Utilization Review Nurse
Oscar Health(1 month ago)
About this role
The Utilization Review Nurse at Oscar works within the Utilization Review team to support appropriate, evidence-based care decisions for members. This remote role, reporting to the Supervisor of Utilization Review, contributes to quality and compliance efforts at a technology-driven health insurer. The position is open to candidates residing in Texas, Georgia, Arizona, and Florida and may require occasional travel for team meetings and events.
Required Skills
- Case Reviews
- Medical Records
- Provider Communication
- Guideline Application
- SLA Adherence
- Care Referrals
- Regulatory Compliance
- MCG
- InterQual
- RN Licensure
Qualifications
- Active RN License
- Nurse Licensure Compact (NLC)
- Associate Degree in Nursing
- Bachelor Of Science In Nursing (BSN)
About Oscar Health
hioscar.comOscar Health is a technology-driven health insurance company offering individual, family, and Medicare plans in select U.S. markets. It pairs insurance coverage with consumer-focused digital tools — a mobile app, telemedicine, and dedicated care teams — to simplify enrollment, care navigation, and claims management. Using data and provider partnerships, Oscar emphasizes preventive care, personalized support, and greater cost transparency for members.
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