Member & Provider Care Specialist

Job Description

Job Description

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

Pay Transparency:

The set rate for this role is $22.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

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
• Bachelor's degree
• High school diploma or GED

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

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.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

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 ([email protected]) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.