California Department of Managed Health Care · 14 hours ago
Complaint Analyst
United States
Full-time
Remote
Mid Level
$6,031/mo - $7,547/moThe California Department of Managed Health Care (DMHC) is dedicated to ensuring health plan members have access to high-quality and affordable health care. The Complaint Analyst will be responsible for evaluating, monitoring, and resolving complaints related to health programs, ensuring compliance with health care regulations and addressing issues raised by various stakeholders.
ComplianceGovernmentHealth Care
No H1B
Responsibilities
Evaluate, monitor and resolve standard complaints and health program activities
Interpret and implement the Knox-Keene Health Care Service Plan Act of 1975 (KKA) and Title 28 of the California Code of Regulations (CCR)
Conduct technical, consultative, and programmatic work within the Standard Complaint Branch (SCB)
Qualification
Required
The position(s) require(s) a Background Investigation be cleared prior to being hired
Possession of Minimum Qualifications will be verified prior to interview and/or appointment
If you are using education to meet the minimum qualifications for this position, you must submit a copy of your high school transcripts or college/university transcript(s)
The Statement of Qualifications (SOQ) is a MANDATORY requirement to apply for this position
Applicants requiring reasonable accommodations for the hiring interview process must request the necessary accommodations if scheduled for a hiring interview
Preferred
Candidates with health care insurance and/or health care services experiences strongly advised
Knowledge of principles, practices, and trends with health care insurance
Ability to work in a fast-paced and customer service-oriented program environment and to organize/prioritize workload to meet demands
Ability to work well under pressure and meet deadlines
Ability to perform multiple tasks with accuracy, precision and neatness
Ability to cultivate collaborative and cohesive working relationships with people in and outside of the team
Ability to provide accurate, clear, and timely advice and direction
Independently resolve consumer complaints within a short time frame
Ability to act independently, with open-mindedness, flexibility, and tact
Provide excellent oral and written communications
Good organizational skills to ensure timely and accurate resolution of complaint cases
Knowledge and proficiency in the use of personal computers and standard office software (i.e. Outlook, Word, Excel, Access and PowerPoint)
Company
California Department of Managed Health Care
California Department of Managed Health Care is a government body that provides health plan oversight and consumer complaint assistance.
Founded in 2000
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Chris Jaeger, MD, MBA
Chief Medical Officer
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