Complaint Analyst
California Department of Managed Health Care, California, MO, United States
Job Overview
Under the direction of the Supervisor I, the Analyst II is assigned complex program‑related responsibilities involving 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 (e.g., Evidence of Coverage), and program policies and procedures. The incumbent evaluates, monitors, and resolves standard complaints and health program activities, including complaints forwarded by various state agencies, and performs technical, consultative, and programmatic work within the Standard Complaint Branch. Responsibilities
Interpret and implement KKA, CCR, and related regulatory documents. Evaluate, monitor, and resolve standard complaints and health program activities. Provide technical, consultative, and programmatic support within the Standard Complaint Branch. Minimum Requirements
Personnel must meet the minimum qualifications stated in the Class Specification for the Analyst II classification. Desirable Qualifications
Experience with health‑care insurance and/or services. Knowledge of principles, practices, and trends in health‑care insurance. Ability to work in a fast‑paced, customer‑service–oriented environment and prioritize workload. Ability to work well under pressure and meet deadlines. Ability to perform multiple tasks accurately, precisely, and neatly. Ability to cultivate collaborative and cohesive working relationships. Ability to provide accurate, clear, and timely advice and direction. Ability to resolve consumer complaints independently within a short time frame. Flexibility, open‑mindedness, and tact. Strong oral and written communication skills. Good organizational skills to ensure timely and accurate resolution of complaint cases. Proficiency with personal computers and standard office software (Outlook, Word, Excel, Access, PowerPoint). Special Requirements
All applicants must pass a background investigation, which may include fingerprinting and a California Department of Justice criminal records check. Benefits
Benefit information can be found on the CalHR website and the CalPERS website. Equal Opportunity Employer
The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (including pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation. The State of California also maintains a drug‑free workplace policy.
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Under the direction of the Supervisor I, the Analyst II is assigned complex program‑related responsibilities involving 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 (e.g., Evidence of Coverage), and program policies and procedures. The incumbent evaluates, monitors, and resolves standard complaints and health program activities, including complaints forwarded by various state agencies, and performs technical, consultative, and programmatic work within the Standard Complaint Branch. Responsibilities
Interpret and implement KKA, CCR, and related regulatory documents. Evaluate, monitor, and resolve standard complaints and health program activities. Provide technical, consultative, and programmatic support within the Standard Complaint Branch. Minimum Requirements
Personnel must meet the minimum qualifications stated in the Class Specification for the Analyst II classification. Desirable Qualifications
Experience with health‑care insurance and/or services. Knowledge of principles, practices, and trends in health‑care insurance. Ability to work in a fast‑paced, customer‑service–oriented environment and prioritize workload. Ability to work well under pressure and meet deadlines. Ability to perform multiple tasks accurately, precisely, and neatly. Ability to cultivate collaborative and cohesive working relationships. Ability to provide accurate, clear, and timely advice and direction. Ability to resolve consumer complaints independently within a short time frame. Flexibility, open‑mindedness, and tact. Strong oral and written communication skills. Good organizational skills to ensure timely and accurate resolution of complaint cases. Proficiency with personal computers and standard office software (Outlook, Word, Excel, Access, PowerPoint). Special Requirements
All applicants must pass a background investigation, which may include fingerprinting and a California Department of Justice criminal records check. Benefits
Benefit information can be found on the CalHR website and the CalPERS website. Equal Opportunity Employer
The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (including pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation. The State of California also maintains a drug‑free workplace policy.
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