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Oscar Health

Member & Provider Care Specialist

Oscar Health

. Solve complex issues or concerns impacting providers and the members they serve .

Posted 10/6/2026full-timeRemote • United StatesJunior💰 $22 per hourWebsite

Core Competencies

Role fit
Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Member and Provider Services, effectively managing complex issues and communications while ensuring compliance with regulations. Proficient in case management and collaboration with cross-functional teams to enhance service delivery.

Highest-signal resume keywords
Customer Support ExperienceClaims ExperienceEscalations ManagementBilingual SpanishKnowledge Management

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills
Case ManagementIssue ResolutionWorkflow ManagementReportingDashboard Management
Soft Skills
CommunicationCollaborationProblem-SolvingTraining SupportTrend Identification
Tools & Technologies
Internal ToolsKnowledge Management System
Industry Keywords
HealthcareMember ServicesProvider ServicesCustomer ServiceFast-Paced Environment

About the role

Key responsibilities & impact
  • Solve complex issues or concerns impacting providers and the members they serve
  • Serve as a subject matter expert for Member and Provider Services
  • Liaise between production teams and optimization/strategy teams
  • Assist with internal questions and training support
  • Communicate with members and providers
  • Contribute to tracking and reporting of network issues
  • Contribute to the knowledge management system
  • Ensure workflows are complete and up to date
  • Manage a queue of assigned cases
  • Handle inbound and outbound calls, secure messages, and/or email communications
  • Manage queue work and assigned caseload through 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
  • 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
  • Partner with production teams across the LifeCycles to improve the member and provider experience
  • Comply with all applicable laws and regulations
  • Perform other duties as assigned

Requirements

What you’ll need
  • 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
  • 1+ years of claims experience (bonus points)
  • Bilingual Spanish (bonus points)

Benefits

Comp & perks
  • Employee benefits
  • Monthly vacation accrual at a rate of 15 days per year
  • Medical benefits
  • Dental benefits
  • Vision benefits
  • 11 paid holidays
  • Paid sick time
  • Paid parental leave
  • 401(k) plan participation
  • Life insurance
  • Disability insurance
  • Paid wellness time and reimbursements