California Department of Managed Health Care · 1 day ago
Complaint Analyst
California, United States
Full-time
Hybrid
New Grad, Entry Level
$3,861/mo - $4,839/moThe California Department of Managed Health Care (DMHC) is dedicated to ensuring health plan members have access to equitable and high-quality health care. They are seeking a Complaint Analyst to evaluate, monitor, and resolve standard complaints while interpreting and implementing relevant health care regulations and policies.
ComplianceGovernmentHealth Care
No H1B
Responsibilities
Evaluating, monitoring, and resolving standard complaints and health program activities
Performing technical, consultative, administrative, and programmatic work within the Standard Complaint Branch (SCB)
Qualification
Required
Effective interpretation and implementation of the Knox-Keene Health Care Service Plan Act of 1975 (KKA)
Knowledge of Title 28 of the California Code of Regulations (CCR)
Understanding of consumer/enrollee contracts, i.e., Evidence of Coverage
Ability to evaluate, monitor, and resolve standard complaints and health program activities
Technical, consultative, administrative, and programmatic work experience
Possession of Minimum Qualifications as verified prior to interview and/or appointment
Background Investigation clearance prior to being hired
Submission of a Statement of Qualifications (SOQ) with the application
Ability to work in a climate-controlled cubicle and/or office environment
California residency required for telework eligibility
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 provide accurate, clear, and timely advice and direction
Independently resolve consumer complaints within a short time frame
Provide excellent oral and written communications
Good organizational skills to ensure timely and accurate resolution of complaint cases
Demonstrated ability to act independently, with open-mindedness, flexibility, and tact
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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