Complaint Analyst

The California Department of Managed Health Care is dedicated to ensuring health plan members have access to equitable and high-quality health care. The Complaint Analyst will assist in evaluating and resolving complaints while implementing health care regulations and policies.

Responsibilities

• Evaluating, monitoring, and resolving standard complaints and health program activities
• Performing technical, consultative, administrative, and programmatic work within the Standard Complaint Branch

Skills

• 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). Unofficial transcripts may be accepted during the application process; however, submission of official transcripts may be required prior to appointment
• The position(s) require(s) a Background Investigation be cleared prior to being hired
• All applicants not currently employed by the DMHC will be subject to a pre-employment background investigation
• Eligibility for this classification requires the equivalent to completion of the 12th grade; candidates must submit high school transcripts or college/university transcript(s) to demonstrate the equivalent to completion of the 12th grade with their application package
• 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
• Experience analyzing complex issues and or writing recommendations
• 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
• Work well under pressure
• 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)

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