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Appeals Analyst

Company: State of California
Location: Sacramento
Posted on: January 26, 2023

Job Description:

Working Conditions Minimum Requirements You will find the Minimum Requirements in the Class Specification.

  • STAFF SERVICES ANALYST (GENERAL) Covered California works to improve the health of all Californians by assuring their access to affordable, high quality healthcare. Our employees are the vital link that ensures that our vision, mission, and values are fully realized and are the driving force that allows us to continually provide exceptional service to those who need it most. We offer an award-winning wellness program, inclusive and diverse atmosphere, employee recognition programs, on site fitness centers at our Sacramento and Service Center locations, and free parking at all of our locations! Life can change in an instant - so can your career! Visit our website to learn more about why Covered California is an employer of choice. Special Requirements Statement of Qualifications (SOQ) Instructions: A SOQ is required to apply. The SOQ will be used as a pre-interview screening tool. Applicants who do not follow the SOQ instructions and/or do not answer the prompt as stated below will not be considered. A Statement of Qualifications (SOQ) must discuss how your education, training, and experience qualifies you for this position. The SOQ must be no more than two pages in length, 12 pt. Arial font, and must address each of the items listed below in the order they are listed. The number and question must be typed in your SOQ before your response.
    • Describe in detail a time when you used your analytical skills to solve a problem. Please answer each of the following:
    • What was the problem?
    • What options did you consider?
    • How did you evaluate your options?
    • What recommendations did you make?
    • What was the outcome?

    • Describe your experience communicating with internal and external customers. What are some essential tools for providing excellent customer service? Please provide an example.

    • Describe your experience applying and communicating policy, regulations, and/or legislation to a diverse audience in a professional setting. What were your strategies for ensuring understanding and how did you handle communication differences? Please provide an example. Application Instructions Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.Final Filing Date: 1/30/2023 Who May Apply Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates apply.

      Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process. Applicants must meet the Minimum Qualifications stated in the Classification Specification(s). How To Apply Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at When submitting your application in hard copy, a completed copy of the Application Package listing must be included.If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below:
      Address for Mailing Application PackagesYou may submit your application and any applicable or required documents to: Covered California Attn: HRB-ECSU-ZCM 1601 Exposition Blvd Sacramento , CA 95815 Address for Drop-Off Application PackagesYou may drop off your application and any applicable or required documents at: Covered California HRB-ECSU-ZCM 1601 Exposition Blvd Sacramento , CA 95815 Monday-Friday 08:00 AM - 05:00 PM Required Application Package DocumentsThe following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:
      • Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
      • Resume is required and must be included.
      • Statement of Qualifications - Statement of Qualifications (SOQ) - Please attach your SOQ to your application. Applications received without an SOQ will not be considered. Resumes and cover letters will not be accepted in place of an SOQ. Please see the above "Special Requirements" section for SOQ instructions.
        Applicants requiring reasonable accommodations for the hiring interview process must request the necessary accommodations if scheduled for a hiring interview. The request should be made at the time of contact to schedule the interview. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this job posting. Desirable Qualifications In addition to evaluating each candidate's relative ability, as demonstrated by quality and breadth of experience, the following factors will provide the basis for competitively evaluating each candidate:
        • Experience in appeals, escalations, complaints, administrative hearings, research and analysis, complex issues, and resolution coordination
        • Experience in the insurance/healthcare industry, and knowledge of the Affordable Health Care Act
        • Experience preparing written statements of position, recommendations, or findings
        • Experience in customer service or call center
        • Familiarity with the Microsoft Office Suite The State of California offers a comprehensive benefits package that includes Health, Vision, Dental, Retirement, and an array of other options. For more information on the benefits offered by the State of California, please click below: The Human Resources Contact is available to answer questions regarding the position or application process. Human Resources Contact:
          Employment & Classification Services Unit
          (916) 228-8386
 Please direct requests for Reasonable Accommodations to the interview scheduler at the time the interview is being scheduled.You may direct any additional questions regarding Reasonable Accommodations or Equal Employment Opportunity for this position(s)to the Department's EEO Office. EEO Contact:
          EEO Office
          (916) 999-8733
 California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice)TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device. Pre-Employment Requirements Background Check: All applicants shall be subject to a pre-employment background investigation. The investigation will consist of completion of a pre-employment questionnaire, fingerprinting, and an inquiry to the Department of Justice and Federal Bureau of Investigation to disclose criminal records. Per GC 100500 (f)(1)'...staff of the Exchange shall not be employed by, a consultant to, a member of the board of directors of, affiliated with, or otherwise a representative of, a carrier or other insurer, and agent or broker, a health care provider, or a health care facility or health clinic while serving on the board or on the staff of the Covered California. A member of the board or of the staff of the Exchange shall not be a member, a board member, or an employee of a trade association of carriers, health facilities, health clinics, or health care providers while serving on the board or on the staff of the Exchange.' Applicants who may fall under Government Code 100500(f)(1) will be considered ineligible for appointment with the Covered California. Additional Application Instructions Using the online application system as specified in the announcement is the preferred method of applying for civil service job opportunities; however, applicants may instead apply by way of U.S. mail, parcel delivery or courier service, or in person, as set forth in this announcement. All information regarding your employment history must be included on the State Employment Application STD. 678. Applications that are submitted blank or with "see resume" in place of duties performed or applications received without the following information for each job entry will be considered incomplete and will not be accepted:
          • "To" and "from" dates (month/day/year)
          • Hours worked per week
          • Private sector job titles
          • Supervisor name and phone number
          • State employees must list the specific departments for which they worked and indicate the specific civil service classification titles held (not working titles). Transcripts: If you are meeting minimum qualifications with education, you must include your unofficial transcript for verification. If selected, you will be required to provide official transcripts at the time of hire. Foreign transcripts must include official verification of U.S equivalency prior to appointment by an organization found here. Personally Identifiable Information: Please do not include your Social Security Number, date of birth, veteran status, personal photos, LEAP information, or any other personally identifying information on any documents in your application package. If you have additional questions regarding this advertisement or are having issues applying through CalCareers, please contact the Employment & Classification Services Unit at 916-228-8386 or . Equal Opportunity EmployerThe State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.It is an objective of the State of California to achieve a drug-free work place. Any applicant for state employment will be expected to behave in accordance with this objective because the use of illegal drugs is inconsistent with the law of the State, the rules governing Civil Service, and the special trust placed in public servants.

Keywords: State of California, Sacramento , Appeals Analyst, Professions , Sacramento, California

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