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Customer Service Representative Sr (OneCare) (Bilingual) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Customer Service Representative Sr (OneCare) (Bilingual) and help shape the future of healthcare where you'll be an integral part of our CS - OneCare Customer Service team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will serve as a senior point of contact for OneCare members and providers and assist them with questions and/or complaints related to the OneCare plan services. You will provide information regarding eligibility, enrollment, benefits and services to OneCare eligible members and providers. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Program Support
<ul>
<li>Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Addresses member and provider inquiries, questions and concerns in all areas, including eligibility, enrollment, claims or authorization status, benefit interpretation and referrals/authorizations for medical care in-person or telephonically.</li>
<li>Serves as a senior resource for other team members (i.e., solves complex challenges, answers uncommon questions and shares complex processes and procedures).</li>
<li>Supports in the coordination of member's health care and social service needs both within and outside the medical group and CalOptima Health.</li>
<li>Enters accurate and complete documentation into internal application systems regarding all concerns and/or inquiries from the member and provider interaction.</li>
<li>Initiates referrals to both internal and external care management departments and other department/government or community agencies.</li>
<li>Maintains departmental productivity and quality standards.</li>
<li>Follows through and completes all member and provider inquiries or requests during the original member and provider interaction. Provides additional follow-up assistance as needed. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>High school diploma or equivalent PLUS 2 years of experience in customer/member service, including 1 year of call center capacity required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>Typing speed of 35 words per minute (WPM) required. </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese) required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>1 year of Health Maintenance Organization (HMO), Medi-Cal/Medicaid and health services experience.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 302 - $49,754 - $69,655 ($23.92 - $33.4880). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Part Time, Full Telework (**If the position is Telework, it is eligible in California only**)
<ul>
<li> *We have two schedules available for this role for this part-time role. Please indicate your preferred shift to apply for, enter "both" if open for both shifts. - Monday - Friday, 10:00 a.m. to 3:00 p.m. - Monday - Friday, 1:00 p.m. to 6:00 p.m. </li>
<li>**Training will be held in the office the first 4 weeks from 8:30am - 5:00pm, Monday - Friday. </li>
</ul>
</li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6690097&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 12, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6690097" target="_blank">https://jobs.caloptima.org/jobs/customer-service-representative-sr-onecare-bilingual-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-b3485a6e5d8eed4aabe9d0bb39035198

Customer Service Representative Sr (OneCare) (Bilingual)

Utilization Review Coordinator Supervisory Role - Behavioral Health. Napa County Salary: $136,219.20 - $163,051.20 Annually Job Type: Full Time Job Number: 2062-2025-10-09 Location: Napa, CA Department: Health &amp; Human Services Agency Closing: Continuous The Napa Valley Napa County is home to 140,000 residents who share a strong sense of community and a legacy of preserving and protecting our rich agricultural heritage. Located in the heart of California's preeminent wine region, the Napa Valley is also part of the dynamic San Francisco Bay Metropolitan Area. With its sunny Mediterranean climate and proximity to the mountains and ocean, the Valley offers residents easy access to virtually unlimited shopping, dining, cultural and recreational opportunities. The Napa Valley's strategic location, natural and cultural resources, history of responsible land use planning and attractive quality of life provide the ideal mix of small town living and big city amenities. Napa County as an Employer As an organization, Napa County is dedicated to improving the lives of our citizens and reflecting the best of the community's values: Respect, Accountability, Dedication, Integrity and Innovation. <a href="https://apptrkr.com/get_redirect.php?id=6639425&amp;targetURL=https://www.countyofnapa.org/721/Working-for-Napa-County" target="_blank">Learn more HERE.</a> The Position It's an exciting time to join Napa County HHSA's Behavioral Health Division. We're improving how we support staff and strengthen the quality of care while putting new statewide reforms-CalAIM and BHSA-into action. These efforts focus on access and better outcomes for the people we serve. The Utilization Review (UR) Coordinator is a supervisory role that leads a small team ensuring that services provided through Napa County Behavioral Health are appropriate, clearly documented, and meet Medi-Cal billing rules. You'll supervise two UR Clinicians, review data and trends, and work closely with program and fiscal staff to make sure services and records are accurate and complete. You'll turn complex regulations into clear, useful guidance for staff, create training materials that make documentation easier, and look for ways to simplify processes so clinicians can focus more on client care. This is a great opportunity to lead a high-performing, collaborative team, help staff succeed, and strengthen a behavioral health system that works better for both providers and clients. Key Responsibilities: 
<ul>
<li>Leadership &amp; Oversight: Supervise and mentor two UR Clinicians, set team priorities, assign workload, and ensure quality and consistency across all utilization review functions.</li>
<li>System Accountability: Lead Behavioral Health UR efforts to meet Medi-Cal, DHCS, and BHIN requirements; analyze patterns in authorizations and utilization to identify system improvements and ensure compliance.</li>
<li>Training &amp; Policy Development: Design and oversee the billing and documentation training program; develop UR policies, workflows, and guidance that make standards clear and achievable.</li>
<li>Collaboration &amp; Problem-Solving: Partner across Behavioral Health, Quality Management, Fiscal, and EHR teams to align processes, resolve barriers, and improve efficiency in documentation and clinical billing practices.</li>
</ul>
 <a href="https://apptrkr.com/get_redirect.php?id=6639425&amp;targetURL=https://www.governmentjobs.com/careers/napacounty/classspecs/1078811?keywords=Utilization&amp;pagetype=classSpecifications" target="_blank">Click here to review the full job description including example of duties and job requirements: HHS Utilization Review Coordinator. </a> <a href="https://apptrkr.com/get_redirect.php?id=6639425&amp;targetURL=https://www.countyofnapa.org/DocumentCenter/View/38195/Recruitment-Flyer-LOD---HHSA" target="_blank">Click here to learn more about HHSA's commitment to learning and serving!</a> This recruitment is being conducted to fill one full-time vacancy. The list established by this recruitment may also be used to fill current and future full-time, part-time, limited term, and extra help vacancies for up to one year. Memorandum of Understanding (MOU) Agreed Salary Increases and Winter Time Off: 3.5% COLA increase effective 7/1/2026 32 hours of Winter Time Off (WTO) POSITION REQUIREMENTS Experience and Education: Any combination of education and experience that would likely provide the required knowledge, skills, and abilities is qualifying. A typical way to obtain the knowledge, skills, and abilities would be: Experience: Four or more years of employment in a program delivering mental health and/or alcohol and drug services supported through state and/or federal funding. Behavioral Health experience is highly desired. Education: A Master's degree in behavioral health or a closely related discipline. License: Possession of one of the following valid licenses issued by the State of California is required: Licensed Clinical Psychologist; Licensed Clinical Social Worker; Licensed Marriage, Family and Child Therapist; Licensed Professional Clinical Counselor (Classification Specifications is under review). Possession of a valid California Driver's License is required. *Any license, certification, or registration required for this position shall be maintained (i.e., active and in good standing) at all times during employment with Napa County. For continued employment with Napa County, you must maintain such license, certification, or registration to meet the minimum qualifications of this position. THE RECRUITMENT PROCESS 1. Applications will be accepted on-line until the current vacancy is filled. 2. Applications will be reviewed for verification of possession of one of the required licenses and supplemental questions reviewed as they are received until the current vacancy is filled. 3. The most qualified candidates from the scoring of the supplemental questions will be invited for an Oral Panel Interview on a continuous basis until the current vacancy is filled. The most qualified candidates from the oral panel interview will be placed on the eligibility list for up to twelve months. Human Resources Department reserves the right to make changes to the recruitment process and schedule at any time. Example of Duties <a href="https://apptrkr.com/get_redirect.php?id=6639425&amp;targetURL=https://www.governmentjobs.com/careers/napacounty/classspecs/1078811?keywords=Utilization&amp;pagetype=classSpecifications" target="_blank">Click here to review the full job description including example of duties and job requirements: HHS Utilization Review Coordinator. </a> Napa County employees automatically become Disaster Service Workers. This means that when Napa County experiences emergencies (earthquake, wildfire, power outage, etc.) you may be asked to pivot from your regular duties to provide critical services to those affected by the emergency (CA Govt Code § 3102). Benefits <a href="https://apptrkr.com/get_redirect.php?id=6639425&amp;targetURL=https://www.countyofnapa.org/DocumentCenter/View/25884/Benefits-Summary---PSE-Supervisory" target="_blank">Learn more about the benefits package for this position here.</a> ADA Accommodation Applicants requiring accommodation during the application and/or selection process pursuant to the Americans with Disabilities (ADA) Act should contact County of Napa Human Resources at (707) 253-4303. Napa County is an Equal Opportunity Employer. To apply, please visit <a href="https://apptrkr.com/6639425" target="_blank">https://www.governmentjobs.com/careers/napacounty/jobs/5107432/utilization-review-coordinator-supervisory-role-behavioral-health</a> Copyright ©2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-32fa2fc7e3a41e4ab7bf05efeb61a85c

2 Part Time Jobs in California