Member & Provider Care Specialist

Oscar HealthOscar HealthArizona, United States
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Posted

10/6/2026

Employment

Full time

Range

$22 - $22/hr

Work style

Remote only

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AI summary

Core responsibilities

The specialist will resolve complex issues for members and providers while managing a caseload and contributing to knowledge management systems. They will act as a liaison between internal teams to identify trends and improve the overall service experience.

Requirements overview

Candidates must have at least one year of experience in customer support, healthcare, or a related field, including specific experience with escalations. Proficiency in a fast-paced environment and the ability to reside in designated states are required.

Key skills

Customer supportHealthcareEscalation managementMember servicesProvider servicesCase managementIssue resolutionKnowledge managementCommunicationData trackingReportingWorkflow managementClaims experience

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About Oscar Health

Industry

Hospitals and Health Care

Employees

2,913

Type

Public Company

Size

1,001-5,000 employees

Oscar Health, Inc. (NYSE: OSCR) is a leading consumer health company that gives people power over their healthcare. Oscar Health serves millions of consumers, employers, brokers, and partners through Oscar Insurance, Lucie Health Marketplace, and Trove Group. Together these businesses deliver exceptional lifestyle products and technology platforms that make healthcare easy to choose, use, and experience.

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Job categories

Customer Service & SupportHealthcareAdministrative

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 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. 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 (accommodations@hioscar.com) 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.

Requirements

  • •Customer support
  • •Healthcare
  • •Escalation management
  • •Member services
  • •Provider services
  • •Case management
  • •Issue resolution
  • •Knowledge management
  • •Communication
  • •Data tracking
  • •Reporting
  • •Workflow management
  • •Claims experience

Benefits

  • •Medical benefits
  • •Dental benefits
  • •Vision benefits
  • •Paid holidays
  • •Paid sick time
  • •Paid parental leave
  • •401(k) plan
  • •Life insurance
  • •Disability insurance
  • •Paid wellness time
  • •Wellness reimbursements
  • •Vacation accrual

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