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US 3w PTO

  • Resolve complex issues impacting providers and members as a subject matter expert.
  • Manage a queue of assigned cases and communicate via calls, messages, and email.
  • Collaborate with production teams to improve the member and provider experience.

Customer Support Healthcare Communication Case Management

20 jobs similar to New Member & Provider Care Specialist

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US

  • Serve as the first point of contact for members across phone and messaging, helping them navigate the app and connect to the right services.
  • Resolve routine virtual-care member issues within Tier 1 scope, documenting interactions clearly and escalating when necessary.
  • Manage multiple workflows and systems to deliver a seamless, member-first experience.

Included Health is a new kind of healthcare company delivering integrated virtual care and navigation. We're on a mission to raise the standard of healthcare for everyone, offering care guidance, advocacy, and access to personalized virtual and in-person care.

$55,000–$65,000/yr
US

  • Serve as first point of contact delivering exemplary service to members and providers via messaging, phone, and live chat.
  • Apply deep product and benefits knowledge to resolve escalations and support QA, bug triage, and emerging workflows.
  • Mentor junior associates and contribute to service recovery and Voice of the Customer feedback loops.

Maven Clinic is the world's largest virtual clinic for women and families, partnering with employers and health plans on family health programs. The company has raised $425M+ and is an award-winning workplace with a mission-driven culture.

US

  • Answer inbound calls and chats with empathy, resolving core member issues like benefits coverage, cost-sharing, and provider searches.
  • Take ownership of issues end-to-end, using established workflows and documenting interactions to ensure continuity of care.
  • Meet quality and member satisfaction standards while navigating Included Health systems and maintaining member confidentiality.

Included Health is a new kind of healthcare company delivering integrated virtual care and navigation to raise the standard of healthcare for everyone. The company is committed to breaking down barriers and providing high-quality care for every person in every community.

$55,890–$73,355/yr
US Unlimited PTO

  • Hire and manage a team of Oscar colleagues with direct responsibility for performance management, growth, and development.
  • Monitor operational KPIs, conduct root-cause analysis, and construct action plans to drive team performance.
  • Serve as a central communicator by leading team huddles and connecting colleagues to Oscar's mission, vision, and values.

Oscar is a health insurance company built around a full stack technology platform and a relentless focus on serving members. They started in 2012 to create a kind of health insurance company that behaves like a doctor in the family, fostering an inclusive culture where people can be their most authentic selves.

US 3w PTO

  • Support the execution of local network strategy and provider outreach to drive membership growth.
  • Meet defined metrics and SLAs including provider outreach and contract completion.
  • Support contract negotiations and document provider feedback to improve processes.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving members. The company started in 2012 to create a health insurance experience that behaves like a doctor in the family.

$22–$26/hr
US

  • Respond to member questions across email, live chat, and outbound phone — covering eligibility, enrollment, billing, program logistics, and technical troubleshooting
  • Meet team goals for response time, first-touch resolution, quality assurance, and member satisfaction (CSAT)
  • Own the member's issue end-to-end — including looping in Care, Implementation, Engineering, or Client Success when a resolution needs their expertise

WellTheory is a digital health company helping people with autoimmune conditions take control of their health through personalized care and nutrition guidance. We're a team of 60+ passionate people who care deeply about helping our members reduce symptoms and live fuller lives.

$50,000–$50,000/yr
US

  • Act as the primary point of contact for patients and providers, handling questions, scheduling, and documentation with empathy and professionalism.
  • Resolve patient and provider issues, escalate complex concerns, and coordinate care activities to ensure seamless support.
  • Track data and trends from support interactions to improve processes and serve as the voice of the patient.

Seven Starling is a leading virtual provider of women's behavioral health services supporting every stage of motherhood. They partner with OBGYN clinics and health plans across the country, and their culture values compassionate care and operational excellence.

US Unlimited PTO

  • Support members through email, live chat, and phone with eligibility and billing questions.
  • Own member issues end-to-end while coordinating with internal teams for resolution.
  • Use AI tools and share feedback to improve support processes and member experience.

This company provides digital healthcare services for ongoing care. It fosters a remote-first culture that values thoughtful communication, sound judgment, and mission-driven work.

US Unlimited PTO

  • Provide empathetic, high-touch support to patients, answering non-clinical questions and navigating their care.
  • Support providers with administrative tasks in the EMR, triaging messages and resolving issues.
  • Coordinate with clinical, pharmacy, and insurance teams to resolve complex patient needs.

Ro is a direct-to-patient healthcare company offering telehealth, labs, and pharmacy services nationwide. With over 1,200 employees, Ro is recognized as a top workplace, fostering a culture of innovation and diversity.

US Unlimited PTO

  • Lead end-to-end Tier 1 and Tier 2 contact center operations across Member, Broker, and Provider channels.
  • Manage a geographically distributed leadership team and build an inclusive, high-accountability remote culture.
  • Drive performance frameworks, workforce management, and technology strategy to scale service operations.

Oscar is a health insurance company built around a full stack technology platform and a relentless focus on serving members. Oscar fosters an inclusive, high-accountability remote culture and is an equal opportunity employer.

US

  • Provide Level III customer service through phone, chat, email, and administrative channels supporting multiple healthcare products and states.
  • Research and resolve complex member and provider issues involving eligibility, benefits, claims, premiums, authorizations, appeals, contracting, credentialing, and related matters.
  • Handle escalated and highly complex calls, including issues raised on behalf of leadership, while applying appropriate risk-based escalation protocols.

The company delivers customer support solutions for healthcare members and providers across multiple lines of business. It operates as a partner organization with a large, remote team focused on high-volume, fast-paced support.

US

  • Triage incoming phone calls from members and pharmacies with professional etiquette.
  • Identify, document, and escalate member and pharmacy concerns to appropriate teams.
  • Ensure first-call resolution and exceptional customer care with genuine compassion.

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. We are an intelligence platform powering benefits plans for millions of Americans, delivering the healthcare we all deserve.

Global Unlimited PTO 16w maternity 16w paternity

  • Serve as first point of contact for members and providers via phone and email, resolving health insurance inquiries.
  • Use active listening and empathy to understand issues, explain benefits, claims, and coverage, and document interactions.
  • Maintain a structured schedule, with availability during peak season, and uphold the Gravie CARE service model and core values.

Gravie creates innovative health benefits for small and midsize businesses, focusing on solutions that genuinely benefit employees. The company is well-funded, non-hierarchical, and merit-driven, with a culture that values authenticity, curiosity, and creativity.

US

  • Handle inbound calls, chats, emails, and faxes from healthcare providers, resolving questions on authorizations, claims, and provider services.
  • Document each interaction, research issues, and ensure accurate, timely follow-up with providers.
  • Guide providers through processes like checking authorization status, submitting claims, and navigating the provider portal.

Curana Health is a national leader in value-based care, offering senior living and skilled nursing facilities solutions such as on-site primary care, ACOs, and Medicare Advantage plans. Founded in 2021, it serves 200,000+ seniors in 1,500+ communities across 32 states with 1,000+ clinicians.

US

  • Manage multiple channel interactions professionally and efficiently.
  • Address provider inquiries with accuracy and focus on first call resolution.
  • Maintain positive relationships and exceed quality and productivity goals.

Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association focused on improving the health and well-being of its members and communities. It has been consistently voted one of the Best Places to Work in PA and fosters a flexible, supportive culture with emphasis on professional growth and community involvement.

$90,000–$115,000/yr
United States Unlimited PTO

  • Own and evolve provider support workflows, automation, and data practices to enable provider success.
  • Partner with clinical leadership across the provider lifecycle from onboarding through retention.
  • Design systems and automation to reduce administrative burden and help prevent provider burnout.

They operate a high-impact telehealth platform focused on improving access to specialized care. The organization is growing and values operational excellence, clinician support, and innovation in workflow automation.

US

  • Provide world-class customer support to patients and advocates via phone, email, and chat.
  • Troubleshoot and resolve client inquiries with empathy and creative problem-solving.
  • Gather and track feedback to improve the Solace platform and client experience.

Solace is a healthcare advocacy company that pairs patients with expert advocates to navigate the complex U.S. healthcare system. It is a Series C startup founded in 2022 with a lean, mission-driven U.S. team and an intense culture focused on redefining healthcare.

$89,600–$141,500/yr
US

  • Lead daily Customer Care operations and oversee Team Leaders to meet SLAs and ensure positive experiences.
  • Hire, coach, and manage remote teams; analyze data to improve processes and workforce alignment.
  • Collaborate with Clinical Operations and Client Account Management on prior auth calls and escalations.

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. We power benefits plans for millions of Americans using a secure Unified Claims Processing platform and AI-driven care delivery.

US

  • Respond to high-volume inquiries via email and phone, assisting with triaging case volumes and providing resolution guidance on complex claims and billing inquiries.
  • Critically analyze situations, escalate issues to appropriate teams, and identify recurring issues to provide feedback to management.
  • Act as a subject matter expert, updating team on resources, supporting team chat, and remaining flexible to take on other duties as assigned.

Privia Health is a technology-driven physician enablement company that collaborates with medical groups, health plans, and health systems to optimize practices and improve patient experiences. They are led by top industry talent and physician leadership, focusing on scalable operations and cloud-based technology to reduce healthcare costs and improve outcomes.

$65,000–$72,000/yr
US Unlimited PTO

  • Provide world-class customer support and resolve complex technical queries for cloud-based healthcare solutions.
  • Develop deep understanding of software to support processes in long-term care facilities and mentor team members.
  • Thoroughly document issues and resolutions via phone, email, chat, and ticketing system, working rotating shifts.

PointClickCare is a leading health tech company that empowers providers to deliver exceptional care through a cloud-based platform with the largest long-term and post-acute care dataset. Privately held and founder-led, the company serves over 30,000 provider organizations, employs thousands, and is recognized by Forbes as a top private cloud company with a Most Admired Corporate Culture.