[Hiring] Member & Provider Care Specialist @Oscar Health

Role Description

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

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 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 communicate 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.

Benefits

• 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.
• Paid wellness time and reimbursements.