Senior Analytical Chemist

Department(s): Customer Service

Reports to: Manager, Customer Service

FLSA status: Non-Exempt

Salary Grade: I - $29.33 - $47.65 ( $61,000 - $99,110)

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Friday, February 16, 2024 at 11:59 PM.
Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

Are you looking for a career that changes lives? As the single largest health plan in Orange County, Cal Optima Health serves one in three residents with health insurance programs for low-income children adults, seniors and people with disabilities. Our 1,500 employees are valued for their individual perspectives and contributions and benefit from flexible work schedules, recognition and opportunities to grow.

If you’re looking for a rewarding career supporting a meaningful mission, along with generous benefits and recognition, consider joining us at Cal Optima Health!

The Supervisor Customer Service (Call Center) will oversee the day-to-day operations of all call center activities, provide supervision to call center staff and provide guidance to the staff as applicable. The incumbent will resolve complex issues and handle escalated calls that a Customer Service Representative Senior or a Customer Service Representative Lead are unable to solve. The incumbent will be required to complete additional research with providers, health networks and internal Cal Optima Health departments to resolve the more complex issues.

• Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.
• Sets priorities for the team to ensure task completion and performance goals are met, such as average speed of answer, abandonment rate, service level, average handle time, quality and staff schedule adherence.
• Identifies and resolves operational problems using defined processes, expertise and judgment.
• Collaborates with Customer Service managers to develop strategies to reinforce, train and disseminate information to meet operational and service performance requirements.
• Fosters and maintains a collaborative relationship with internal and external business partners to ensure member and provider satisfaction.
• Prepares requested materials for the Healthcare Effectiveness Data and Information Set (HEDIS), National Committee for Quality Assurance (NCQA), California Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC) and Audit and Oversight audits.
• Oversees the exempt grievance process as it relates to Customer Service to ensure all state and federal regulations are achieved.
• Participates in cross-functional project teams that ultimately improve the member experience.
• Contributes subject matter expertise and carries out project assignments in a timely and effective manner.
• Facilitates the planning of the department’s quarterly meetings.
• Assists with new hire recruitment and interviews.
• Monitors employee’s timekeeping and schedule adherence.
• Holds individual monthly 1:1s with each team member to review call audits and attendance.
• Provides coaching, feedback and annual performance reviews, as well as formal corrective action as needed.
• Completes other projects and duties as assigned.

• High School diploma or equivalent required.
• 3 years of health care or call center experience required; preferably in a managed care environment or in a related area.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.

• Bachelor’s degree.
• 1 year of supervisory or lead work…