California Department of Managed Health Care
Complaint Analyst
California Department of Managed Health Care, California, Missouri, United States, 65018
Overview
Job Description And Duties
The recruitment has been posted for more vacancies than currently exist as it may be used to fill additional identical vacancies which may occur within 180 days of the closing date of this bulletin. The DMHC Help Center educates members about their health care rights and resolves complaints against health plans to ensure a stable and accessible health care delivery system. Under the direction of the Supervisor I, the Analyst II is assigned the more complex program-related responsibilities using the interpretation and implementation of the Knox-Keene Health Care Service Plan Act of 1975 (KKA), Title 28 of the California Code of Regulations (CCR), consumer/enrollee contracts (Evidence of Coverage), and program policies and procedures. The Standard Complaint Branch (SCB) incumbent is responsible for evaluating, monitoring and resolving standard complaints and health program activities, including complaints that have been forwarded by the Governor, Legislature, California Health & Human Services Agency, DMHC Director, or any of the DMHC’s Executive offices. The incumbent will perform technical, consultative, and programmatic work within SCB. Working Conditions
The DMHC has locations in Downtown Sacramento and Rancho Cordova. The incumbent will work in a climate-controlled cubicle and/or office environment with artificial lighting. This position may be eligible for hybrid telework and is subject to the State Telework Policy and the DMHC Telework Policy. All employees who telework are required to be California residents and maintain California residency in accordance with Government Code 14200. Minimum Requirements
You will find the Minimum Requirements in the Class Specification.
ANALYST II Position Details
Job Code #:
JC-505392 Position #(s):
409-161-5393-XXX Working Title:
Complaint Analyst Classification:
ANALYST II Salary:
$6,031.00 - $7,547.00 A Job Type:
Permanent, Full Time Work Location:
Sacramento County Telework:
Hybrid Department Information
The mission of the Department of Managed Health Care (DMHC) is to ensure health plan members have access to equitable, high-quality, timely, and affordable health care within a stable health care delivery system. DMHC protects health care rights of 30.2 million Californians by regulating health care service plans, assisting consumers through a Help Center, educating consumers on rights and responsibilities and preserving financial stability of the system. DMHC values diversity and is committed to fostering an inclusive environment. The department may offer the Someone Like Me program to help candidates learn about DMHC culture. Application must be completed through Cal Careers. Not all information will be relayed to the Hiring Unit. Department Website: http://www.dmhc.ca.gov Desirable Qualifications
In addition to evaluating each candidate’s ability, the following factors provide the basis for competitive evaluation: Candidates with health care insurance and/or health care services experience Knowledge of health care insurance principles, practices, and trends Ability to work in a fast-paced, customer-service oriented environment and to organize/prioritize workload Ability to work under pressure and meet deadlines Ability to perform multiple tasks with accuracy and neatness Ability to cultivate collaborative working relationships Ability to provide accurate, clear, and timely advice Independently resolve consumer complaints quickly Ability to act with flexibility and tact Strong oral and written communications Good organizational skills for timely resolution of complaint cases Proficiency with personal computers and standard office software (Outlook, Word, Excel, Access, PowerPoint) Application Information
Required Documents The following items are required to be submitted with your application. Incomplete submissions may not be considered: State Examination/Employment Application STD Form 678 (or electronic application) Resume (optional) Statement of Qualifications (SOQ) – mandatory SOQ responses should be no more than two pages in Arial 12-point font. Include a title at the top and your name and job code in the header. Submit responses to the following prompts and ensure SOQ is included with the application packet. Examples of analyzing issues with interpretation and application of laws/regulations/policies Experience adapting communication style to diverse audiences Experience addressing problems with dissatisfied customers Applicants must meet Minimum Qualifications; foreign degree/transcript evaluations may be required. How to Apply
Submit application packages electronically via CalCareers.ca.gov or by mail to the Department of Managed Health Care, DMHC Recruitment, Attn: Human Resources Office, 980 9th Street, Suite 500, Sacramento, CA 95814. Hand-delivered applications must be submitted by 5:00 p.m. on the final filing date. Final Filing Date: 2/2/2026. Equal Opportunity and Reasonable Accommodations
The State of California is an equal opportunity employer. Reasonable accommodations information is available from the EEO Office. EEO contact: (916) 738-3394, EEO@dmhc.ca.gov. California Relay Service: 1-800-735-2929 (TTY) / 1-800-735-2922 (Voice). Other
Special Requirements: A background investigation is required prior to hire. All applicants will undergo fingerprinting and DOJ inquiry. Do not include confidential information in documents. For more details see the posting. This description reflects information current at the time of posting.
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Job Description And Duties
The recruitment has been posted for more vacancies than currently exist as it may be used to fill additional identical vacancies which may occur within 180 days of the closing date of this bulletin. The DMHC Help Center educates members about their health care rights and resolves complaints against health plans to ensure a stable and accessible health care delivery system. Under the direction of the Supervisor I, the Analyst II is assigned the more complex program-related responsibilities using the interpretation and implementation of the Knox-Keene Health Care Service Plan Act of 1975 (KKA), Title 28 of the California Code of Regulations (CCR), consumer/enrollee contracts (Evidence of Coverage), and program policies and procedures. The Standard Complaint Branch (SCB) incumbent is responsible for evaluating, monitoring and resolving standard complaints and health program activities, including complaints that have been forwarded by the Governor, Legislature, California Health & Human Services Agency, DMHC Director, or any of the DMHC’s Executive offices. The incumbent will perform technical, consultative, and programmatic work within SCB. Working Conditions
The DMHC has locations in Downtown Sacramento and Rancho Cordova. The incumbent will work in a climate-controlled cubicle and/or office environment with artificial lighting. This position may be eligible for hybrid telework and is subject to the State Telework Policy and the DMHC Telework Policy. All employees who telework are required to be California residents and maintain California residency in accordance with Government Code 14200. Minimum Requirements
You will find the Minimum Requirements in the Class Specification.
ANALYST II Position Details
Job Code #:
JC-505392 Position #(s):
409-161-5393-XXX Working Title:
Complaint Analyst Classification:
ANALYST II Salary:
$6,031.00 - $7,547.00 A Job Type:
Permanent, Full Time Work Location:
Sacramento County Telework:
Hybrid Department Information
The mission of the Department of Managed Health Care (DMHC) is to ensure health plan members have access to equitable, high-quality, timely, and affordable health care within a stable health care delivery system. DMHC protects health care rights of 30.2 million Californians by regulating health care service plans, assisting consumers through a Help Center, educating consumers on rights and responsibilities and preserving financial stability of the system. DMHC values diversity and is committed to fostering an inclusive environment. The department may offer the Someone Like Me program to help candidates learn about DMHC culture. Application must be completed through Cal Careers. Not all information will be relayed to the Hiring Unit. Department Website: http://www.dmhc.ca.gov Desirable Qualifications
In addition to evaluating each candidate’s ability, the following factors provide the basis for competitive evaluation: Candidates with health care insurance and/or health care services experience Knowledge of health care insurance principles, practices, and trends Ability to work in a fast-paced, customer-service oriented environment and to organize/prioritize workload Ability to work under pressure and meet deadlines Ability to perform multiple tasks with accuracy and neatness Ability to cultivate collaborative working relationships Ability to provide accurate, clear, and timely advice Independently resolve consumer complaints quickly Ability to act with flexibility and tact Strong oral and written communications Good organizational skills for timely resolution of complaint cases Proficiency with personal computers and standard office software (Outlook, Word, Excel, Access, PowerPoint) Application Information
Required Documents The following items are required to be submitted with your application. Incomplete submissions may not be considered: State Examination/Employment Application STD Form 678 (or electronic application) Resume (optional) Statement of Qualifications (SOQ) – mandatory SOQ responses should be no more than two pages in Arial 12-point font. Include a title at the top and your name and job code in the header. Submit responses to the following prompts and ensure SOQ is included with the application packet. Examples of analyzing issues with interpretation and application of laws/regulations/policies Experience adapting communication style to diverse audiences Experience addressing problems with dissatisfied customers Applicants must meet Minimum Qualifications; foreign degree/transcript evaluations may be required. How to Apply
Submit application packages electronically via CalCareers.ca.gov or by mail to the Department of Managed Health Care, DMHC Recruitment, Attn: Human Resources Office, 980 9th Street, Suite 500, Sacramento, CA 95814. Hand-delivered applications must be submitted by 5:00 p.m. on the final filing date. Final Filing Date: 2/2/2026. Equal Opportunity and Reasonable Accommodations
The State of California is an equal opportunity employer. Reasonable accommodations information is available from the EEO Office. EEO contact: (916) 738-3394, EEO@dmhc.ca.gov. California Relay Service: 1-800-735-2929 (TTY) / 1-800-735-2922 (Voice). Other
Special Requirements: A background investigation is required prior to hire. All applicants will undergo fingerprinting and DOJ inquiry. Do not include confidential information in documents. For more details see the posting. This description reflects information current at the time of posting.
#J-18808-Ljbffr