Member & Provider Care Specialist

Hi, we're Oscar. We're hiring a Care Specialist to join our Member & Provider Escalations team.

Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

You will solve complex issues or concerns impacting our providers and the members they serve. You will be a subject matter expert for Member and Provider Services. You will be a liaison between production teams and optimization/strategy teams. You will assist with internal questions and training support and communicate with our Members and Providers. You will contribute to the tracking and reporting of network issues and are a key contributor to our knowledge management system.

You will ensure workflows are complete and up to date while also managing a queue of assigned cases.

You will report into Member Escalations Operations Manager.

Work Location:

This is a remote role.

You must reside in Arizona, Florida, Georgia, or Texas.

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. #LI-Remote

Responsibilities

• Handle inbound and outbound calls, secure messages and/or email communications with members or providers
• Manage queue work and and assigned caseload through efficient dashboard management
• Identify, investigate, and resolve issues within determined SLAs
• Collaborate with colleagues, Experts, and Leads to identify trends and roadblocks
• Utilize internal tools and resources seamlessly
• Effectively communicates findings and resolutions with providers and internal departments
• Support Member and Provider Services Representatives with complex issues, workflows, and training
• Escalate updates or incorrect information in the internal knowledge management system for Member and Provider Services
• Partner with production teams across the LifeCycles to improve the member and provider experience
• Compliance with all applicable laws and regulations
• Other duties as assigned

Qualifications

• 1+ years in customer support, healthcare, tech and/or related field
• Experience in a fast-paced environment
• 6 + months of member and customer service experience
• 1+ year of escalations experience in a customer service environment
• Bonus Points
• 1 + years of claims experience
• Bilingual Spanish
• This is an authentic Oscar Health job opportunity.
• At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Artificial Intelligence (AI):

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Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

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