This 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 Department of Managed Health Care's Help Center assists health plan members with health care issues and through its regulatory authority ensures that managed health plan members receive the medical care and services to which they are entitled. Under direction of the Standard Complaint Branch (SCB)'s Staff Services Manager III, the Health Program Specialist I is responsible for all phases and direct oversight of the SCB's operations and activities pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (KKA), Title 28 of the California Code of Regulations, consumer/enrollee contracts, i.e., Evidence of Coverage, and program policies and procedures. The incumbent is responsible for the most difficult, complex, and sensitive consumer complaints and trend analysis, including providing recommendations to management, performing audits, and training.
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Job Type
Full-time
Career Level
Entry Level
Industry
Executive, Legislative, and Other General Government Support
Education Level
Bachelor's degree
Number of Employees
5,001-10,000 employees