Customer Care Specialist

Evolving Solution Services; Roseburg (OR); On-site; USD 42,000 - 47,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k) with company match and vesting

Paid time off and holidays

Job summary

Umpqua Health in Roseburg, OR is seeking a Customer Care Specialist to provide empathetic, accurate support to members regarding benefits, eligibility, and health services. You will be the primary contact by phone, email, or in writing, ensuring timely resolutions and a positive member experience.

The role collaborates with Care Coordination, Behavioral Health, and Claims teams, documents interactions in case-management systems, and upholds HIPAA privacy.

Qualifications

• High school diploma or equivalent required.
• Valid driver’s license and proof of current automobile insurance required.
• Minimum of two (2) years of customer service experience, preferably in healthcare, insurance, or public service environments.
• Experience working in healthcare, insurance, or public service settings.
• Strong communication skills, including active listening and clear verbal and written communication.
• Ability to de-escalate challenging situations with empathy and professionalism.
• Proficiency using multiple systems simultaneously, including call center or case management platforms and Microsoft Office Suite.
• Experience working on diverse teams and adapting to different communication styles.
• Commitment to serving diverse populations with cultural sensitivity and equitable service delivery.
• Strong professionalism, reliability, confidentiality, and accountability in healthcare environments.

Responsibilities

• Serve as primary contact for members via phone, email, and written correspondence.
• Provide accurate information on benefits, eligibility, and health plan navigation.
• Conduct proactive outreach to welcome members and promote preventive care.
• Research issues across systems and provide clear resolutions.
• Collaborate with Care Coordination, Provider Relations, Behavioral Health, and Claims teams.
• Document all member interactions in call tracking and case management systems.
• Maintain confidentiality and HIPAA compliance.
• Educate members on health plan benefits and services.
• Connect members to community resources and social support services.
• Identify trends and suggest process improvements.

Skills

Customer service

Healthcare knowledge

Communication skills

HIPAA compliance

Multitasking

Education

High school diploma

Tools

Microsoft Office

Call center software

Job description

Location: 3031 NE Stephens St. Roseburg, OR 97470
Employment Type: Full-Time, Exempt
Schedule: Monday–Friday, 8:00 a.m.–5:00 p.m.
Salary Range: $20.00- $22.50

ABOUT UMPQUA HEALTH

At Umpqua Health, we’re more than a healthcare organization—we’re a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination.

POSITION PURPOSE The Customer Care Specialist is responsible for providing high-quality, empathetic, and accurate support to members by responding to inquiries regarding benefits, eligibility, and general healthcare services. This role serves as a primary point of contact for member communications, handling both written and telephone interactions to ensure timely and effective resolution of questions and concerns. The position plays a key role in enhancing the members’ experience by building positive relationships, advocating for member needs, and supporting access to healthcare services. Through responsive and solution-focused communication, the Customer Care Specialist contributes to the organization’s commitment to delivering accessible, compassionate, and member-centered care.

ESSENTIAL JOB RESPONSIBILITIES

• Serve as the primary point of contact for members via phone, email, written correspondence, and occasional in-person interactions, providing accurate information on benefits, eligibility, care coordination, and health plan navigation.
• Conduct proactive outreach to new and returning members to welcome them, explain available services, promote preventive care, and encourage engagement in health management and follow-up care.
• Listen to member concerns, research issues using multiple systems, and provide clear, empathetic, and accurate resolutions to support member understanding and trust.
• Collaborate with internal departments such as Care Coordination, Provider Relations, Behavioral Health, Utilization Management, and Claims to resolve member needs efficiently and in accordance with organizational policies and regulations.
• Document all member interactions accurately and timely in call tracking and case management systems to ensure compliance and continuity of care.
• Maintain strict confidentiality and comply with HIPAA and all privacy and security requirements.
• Educate members on health plan benefits, including provider access, prior authorization processes, pharmacy benefits, wellness programs, and available services.
• Connect members to community resources and social support services such as housing, food assistance, transportation, and behavioral health supports.
• Identify trends, recurring issues, and service gaps and provide recommendations for process improvement and enhanced member experience.

MINIMUM QUALIFICATIONS

• High school diploma or equivalent required.
• Valid driver’s license and proof of current automobile insurance required.
• Valid eligibility to participate in federal healthcare programs (no suspension, exclusion, or debarment from Medicare/Medicaid or similar programs).
• Minimum of two (2) years of customer service experience, preferably in healthcare, insurance, or public service environments.
• Experience working in healthcare, insurance, or public service settings.
• Strong communication skills, including active listening, clear verbal communication, and professional written communication.
• Ability to de-escalate challenging situations with empathy, patience, and professionalism.
• Proficiency using multiple systems simultaneously, including call center or case management platforms and Microsoft Office Suite (Outlook, Word, Excel).
• Experience working on diverse teams and adapting to different communication styles.
• Experience supporting or serving diverse communities, including communities of color.
• Collaborative, team-oriented mindset with a proactive approach to problem-solving and continuous service improvement.
• Commitment to serving diverse, underserved, rural, and vulnerable populations with cultural sensitivity and equitable service delivery.
• Strong professionalism, reliability, adherence to confidentiality, compliance, and accountability standards in a healthcare environment.

PREFERRED QUALIFICATIONS

• Some college coursework or certifications in healthcare, human services, customer service, or medical administration.
• Bilingual or translation capabilities are a plus.

BENEFITS

• Compensation based on skills, experience, and education.
• Generous vacation PTO, sick leave, federal holidays, and birthday leave.
• Medical, dental, and vision insurance.
• 401(k) with company match and immediate vesting.
• Company-sponsored life insurance and additional benefits.
• Fitness reimbursement program.
• Tuition reimbursement and professional development opportunities.

WHY UMPQUA HEALTH?

At Umpqua Health, every team member plays an important role in improving health, expanding access to care, and strengthening the communities we serve.

Inclusive Culture: We foster a respectful and inclusive environment where employees feel valued, supported, and empowered.
Growth & Development : We support continued learning through mentorship, career pathways, and professional development opportunities.
Work-Life Balance: We promote flexibility and well-being so employees can thrive professionally and personally.

EQUAL OPPORTUNITY EMPLOYER

Umpqua Health is an equal opportunity employer committed to creating a respectful and inclusive workplace. Employment decisions are based on qualifications, merit, and business needs without regard to race, color, religion, sex, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other status protected under federal, state, or local law.