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Customer Service Coordinator (Medi-Cal Customer Service) CalOptima CalOptima Health is seeking a highly motivated Customer Service Coordinator (Medi-Cal Customer Service) to join our team. The Customer Service Coordinator (Medi-Cal Customer Service) will be responsible for providing quality service to members, conducting member-focused research and assisting with other call center activities. The incumbent will coordinate members' health care needs by engaging with health networks, providers and other CalOptima Health departments. The incumbent will remain current on the latest information about CalOptima Health's member benefits, policies and procedures in order to provide accurate information/case resolutions to members. Position Information: 
<ul>
<li>Department: CS - Medi-Cal Call Center </li>
<li>Salary Grade: 303 - $51,744 - $72,441 ($24.88 - $34.8274) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
<ul>
<li>Duties &amp; Responsibilities:</li>
</ul>
<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>Coordinates and handles case load, researches and ensures cases are resolved within departmental and regulatory standards.</li>
<li>Maintains documentation of member cases in CalOptima Health's system.</li>
<li>Provides assistance and education to members regarding benefits, health coverage and continuity of care issues.</li>
<li>Initiates referrals to both internal and external care management departments and other government or outside agencies.</li>
<li>Assesses members' concerns to identify health care issues and facilitates an appropriate resolution.</li>
<li>Communicates with community-based organizations, health networks, providers and vendors on behalf of members to resolve disputes, helps coordinate access to care and investigates issues preventing members from receiving medical benefits and services.</li>
<li>Identifies cases needing case management or escalation to a supervisor, manager, or director and routes according to established guidelines.</li>
<li>Provides input towards developing, maintaining and updating training documents and desktop procedures as needed.</li>
<li>Handles escalated member and provider calls as needed. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned.</li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High school diploma or equivalent PLUS 2 years of experience as a call center agent or customer/member service in a health care setting or managed care plan 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>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese) required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Associate's degree in health care administration or related field.</li>
<li>1 year of experience handling health care coordination/casework in a customer/member service capacity.</li>
<li>Experience in Health Maintenance Organization (HMO), Medi-Cal/Medicaid and Health Services.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6374315&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS 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 July 23, 2025 at 9:00 PM (PST). 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. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6374315" target="_blank">https://jobs.caloptima.org/jobs/customer-service-coordinator-medi-cal-customer-service-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-8512a2f9aba4ba44a98c4aa03571e9ea

Customer Service Coordinator (Medi-Cal Customer Service)

Customer Service Representative CalOptima CalOptima Health is seeking a highly motivated Customer Service Representative to join our team. The Customer Service Representative (CSR) will be the first line of contact for CalOptima Health's members and providers. The incumbent will assist members and providers with questions and/or complaints related to the Medi-Cal programs for Orange County. The incumbent will provide information regarding eligibility, enrollment, benefits and services to CalOptima Health's eligible members and providers. Position Information: 
<ul>
<li>Department: Customer Service </li>
<li>Salary Grade: 301 - $47,840 - $64,584 ($23.00 - $31.0500) </li>
<li>Work Arrangement: Full Office </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>80% - 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>Maintains departmental productivity and quality standards.</li>
<li>Follows through on and completes all member and provider inquiries or requests during the original member and provider interaction.</li>
<li>Serves as a resource for other team members. </li>
</ul>
</li>
<li>15% - Administrative Support
<ul>
<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>Enters accurate and complete documentation into internal application systems regarding all concerns and/or inquiries from the member and provider interaction.</li>
<li>Communicates, builds and maintains internal and external relationships by prompt and accurate service delivery.</li>
<li>Identifies and communicates challenges that might arise with the use of professional judgment while adhering to departmental policies and procedures. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High School diploma or equivalent PLUS 6 months of experience in a 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>
</ul>
 Preferred Qualifications: 
<ul>
<li>6 months of Medi-Cal/Medicaid or health services experience.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6337909&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS 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 July 15, 2025 at 9:00 PM (PST). 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. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6337909" target="_blank">https://jobs.caloptima.org/jobs/customer-service-representative-505-city-parkway-west-california-united-states-7d5bf04b-390c-46e1-91cb-12f6a1dd6e9a</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-fa21bddb4c4a0240925cf86da2f60f27

Customer Service Representative

Manager Grievance &amp; Appeals (Provider Services) CalOptima CalOptima Health is seeking a highly motivated an experienced Manager, Grievance &amp; Appeals (Provider Services) to join our team. The Manager Grievance &amp; Appeals (Provider Services) will provide daily oversight and technical management for provider services, including provider disputes, provider grievances and provider appeal to ensure compliance with state, federal and accreditation standards applicable to CalOptima Health. The incumbent will work with CalOptima Health management staff and other affiliated health networks with a close interface to the program and process, including areas such as Utilization Management, Claims Administration, Delegation Oversight, Quality Improvement and health network relations. The incumbent will research complex claims problems, isolate root causes and partner with various entities for resolution. The incumbent will communicate with all levels of internal staff, regulatory agencies, health networks, providers, vendors, community-based organizations and medical groups. Position Information: 
<ul>
<li>Department: GA - Provider Disputes </li>
<li>Salary Grade: 315 - $109,892 - $175,827 ($52.83 - $84.5322) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>50% - Program Oversight
<ul>
<li>Identifies and analyzes trends, collaborates with the Director to provide trends and makes recommendations for improvement.</li>
<li>Stays current on the local, state and federal health care environment, identifying issues that may impact CalOptima Health's programs as they relate to claims, provider disputes, grievances and provider appeals.</li>
<li>Develops, implements, maintains and reviews the adequacy of the CalOptima Health provider grievance systems, reporting, policies and functions to achieve stated goals, including, but not limited to, complaint resolution and timely responsiveness for all lines of business, to ensure compliance with all relevant regulatory requirements pertaining to provider disputes.</li>
<li>Works with the Audit and Oversight department and key departments to ensure internal departments and external partners (e.g., health networks and delegates) are up to date with regulatory, departmental and organizational changes impacting the grievance and appeals processes.</li>
<li>Ensures timely and effective data collection, summarization, integration and reporting, including, but not limited to, productivity, status and trend reports for specific committees such as the Quality Improvement Committee, Grievance and Appeals Committee, Quality Assurance Committee of the Board of Directors and other ad hoc reporting as required.</li>
<li>Serves as CalOptima Health's primary point of contact and subject matter expert related to provider services (disputes, grievances and appeals).</li>
<li>Participates in Department of Managed Healthcare (DMHC), Department of Health Care Services (DHCS) and Centers for Medicare and Medicaid (CMS) audits related to area of responsibility for all CalOptima Health programs. </li>
</ul>
</li>
<li>45% - Leadership
<ul>
<li>Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department.</li>
<li>Manages, hires, mentors and develops department staff.</li>
<li>Oversees the development and maintenance of internal policies and procedures and desktops to ensure compliance with all state and federal regulations for multiple lines of business.</li>
<li>Manages and makes recommendations on the development and maintenance of an effective dispute, appeals and grievance process and systems consistent with CalOptima Health policies and stated goals, including, but not limited to mechanisms to monitor provider disputes, grievances and appeals involving Legal, DMHC, DHCS, Independent Medical Review, Medi-Cal State Hearings, Office of Administrative Hearings and Appeals, CMS and external review agencies for CMS.</li>
<li>Partners with the management to ensure appropriate training and auditing tools are developed and maintained for the department. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in business administration, nursing, healthcare administration or related field PLUS 3 years of health care management experience in a related area of responsibility (provider disputes and appeals, claims administration, appeals and grievances) 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>3 years of leadership experience required. </li>
<li>Experience in health maintenance organization, Medi-Cal/Medicaid, Medicare Advantage, Medicare Part D, Special Needs Plans, Medicare-Medicaid Plans and/or the Program of All-Inclusive Care for the Elderly required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Experience with process improvement implementation.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Monday or Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6357344&amp;targetURL=https://alliantbenefits.cld.bz/24caloptimacabenguide" target="_blank">2024 CalOptima Health Benefits Guide</a> and our <a href="https://apptrkr.com/get_redirect.php?id=6357344&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS 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 July 16, 2025 at 9:00 PM (PST). 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. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6357344" target="_blank">https://jobs.caloptima.org/jobs/manager-grievance-appeals-provider-services-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-cf7b2c04c4b10840a8654602344b5194

Manager Grievance & Appeals (Provider Services)

Job Position: Part Time School Food Service Aides.
Location: Reading School District.
Pay Rate: $15.00/ Hour.
Shift: Work: 4 hour morning shifts, could work up to 6 hours a day.
Job Title: School Cafeteria Food Service Aide
Job Summary: We are seeking dedicated individuals to join SOS Group as School Cafeteria Food Service Aides. As a vital part of our school community, you will play a crucial role in ensuring the smooth and efficient operation of the cafeteria. Your primary responsibilities will include assisting in food preparation, serving meals, maintaining a clean and organized dining area, and providing excellent customer service to students and staff.
Responsibilities:
<ol>
<li>
Food Preparation:
</li>
</ol>
<ul>
<li>
Assist in the preparation of meals according to established recipes and portion sizes.
</li>
<li>
Follow food safety and sanitation guidelines to ensure the quality and safety of meals.
</li>
</ul>
<ol>
<li>
Meal Service:
</li>
</ol>
<ul>
<li>
Serve meals to students and staff in a courteous and efficient manner.
</li>
<li>
Monitor portion control to minimize waste and ensure all individuals receive appropriate servings.
</li>
</ul>
<ol>
<li>
Cleanliness and Organization:
</li>
</ol>
<ul>
<li>
Maintain a clean and sanitized work environment, including kitchen and dining areas.
</li>
<li>
Clean and sanitize utensils, dishes, and equipment regularly.
</li>
<li>
Dispose of waste and ensure proper recycling procedures are followed.
</li>
</ul>
<ol>
<li>
Team Collaboration:
</li>
</ol>
<ul>
<li>
Work collaboratively with other cafeteria staff to ensure a cohesive and efficient operation.
</li>
<li>
Communicate effectively with kitchen and cafeteria personnel.
</li>
</ul>
Qualifications:
<ul>
<li>
Minimum of a high school diploma or equivalent.
</li>
<li>
State and federal Background checks required.
</li>
<li>
Excellent communication and interpersonal skills.
</li>
<li>
Ability to lift up to 50 pounds.
</li>
<li>
Physically capable of standing for extended periods and moving quickly if necessary.
</li>
</ul>
<ol>
<li></li>
</ol>

Food Service Aide

Job Position: Part Time Food Service Aide
Location: Hempfield School District.
Pay Rate: $14.25/ Hour.
Shift: M-Fr, 8:00am-2:00pm
Job Title: School Cafeteria Food Service Aide
Job Summary: We are seeking dedicated individuals to join SOS Group as School Cafeteria Food Service Aides. As a vital part of our school community, you will play a crucial role in ensuring the smooth and efficient operation of the cafeteria. Your primary responsibilities will include assisting in food preparation, serving meals, maintaining a clean and organized dining area, and providing excellent customer service to students and staff.
Responsibilities:
<ol>
<li>
Food Preparation:
</li>
</ol>
<ul>
<li>
Assist in the preparation of meals according to established recipes and portion sizes.
</li>
<li>
Follow food safety and sanitation guidelines to ensure the quality and safety of meals.
</li>
</ul>
<ol>
<li>
Meal Service:
</li>
</ol>
<ul>
<li>
Serve meals to students and staff in a courteous and efficient manner.
</li>
<li>
Monitor portion control to minimize waste and ensure all individuals receive appropriate servings.
</li>
</ul>
<ol>
<li>
Cleanliness and Organization:
</li>
</ol>
<ul>
<li>
Maintain a clean and sanitized work environment, including kitchen and dining areas.
</li>
<li>
Clean and sanitize utensils, dishes, and equipment regularly.
</li>
<li>
Dispose of waste and ensure proper recycling procedures are followed.
</li>
</ul>
<ol>
<li>
Team Collaboration:
</li>
</ol>
<ul>
<li>
Work collaboratively with other cafeteria staff to ensure a cohesive and efficient operation.
</li>
<li>
Communicate effectively with kitchen and cafeteria personnel.
</li>
</ul>
Qualifications:
<ul>
<li>
Minimum of a high school diploma or equivalent.
</li>
<li>
State and Federal Background checks required.
</li>
<li>
Excellent communication and interpersonal skills.
</li>
<li>
Ability to lift up to 50 pounds.
</li>
<li>
Physically capable of standing for extended periods and moving quickly if necessary.
</li>
</ul>

Job Position: Food Service Aide
Location: Downingtown, PA 19335
Pay Rate: $15.50/hr
Shift: Monday-Friday. Various shifts available as early as 6:45 am and as late as 2:15 pm. Between 20-32.5 hours per week available.
Job Summary: We are seeking dedicated individuals to join SOS Group as School Cafeteria Food Service Aides. As a vital part of our school community, you will play a crucial role in ensuring the smooth and efficient operation of the cafeteria. Your primary responsibilities will include assisting in food preparation, serving meals, maintaining a clean and organized dining area, and providing excellent customer service to students and staff.
Responsibilities:
<ol>
<li>
Food Preparation:
</li>
</ol>
<ul>
<li>
Assist in the preparation of meals according to established recipes and portion sizes.
</li>
<li>
Follow food safety and sanitation guidelines to ensure the quality and safety of meals.
</li>
</ul>
<ol>
<li>
Meal Service:
</li>
</ol>
<ul>
<li>
Serve meals to students and staff in a courteous and efficient manner.
</li>
<li>
Monitor portion control to minimize waste and ensure all individuals receive appropriate servings.
</li>
</ul>
<ol>
<li>
Cleanliness and Organization:
</li>
</ol>
<ul>
<li>
Maintain a clean and sanitized work environment, including kitchen and dining areas.
</li>
<li>
Clean and sanitize utensils, dishes, and equipment regularly.
</li>
<li>
Dispose of waste and ensure proper recycling procedures are followed.
</li>
</ul>
<ol>
<li>
Team Collaboration:
</li>
</ol>
<ul>
<li>
Work collaboratively with other cafeteria staff to ensure a cohesive and efficient operation.
</li>
<li>
Communicate effectively with kitchen and cafeteria personnel.
</li>
</ul>
Qualifications:
<ul>
<li>
Minimum of a high school diploma or equivalent.
</li>
<li>
State and Federal Background checks required.
</li>
<li>
Excellent communication and interpersonal skills.
</li>
<li>
Ability to lift up to 50 pounds.
</li>
<li>
Physically capable of standing for extended periods and moving quickly if necessary.
</li>
</ul>

Job Position: Substitute School Food Service Aides.
Location: Radnor School District.
Pay Rate: $16.32/ Hour.
Shift: Flexible Various shifts Monday - Friday, 8:00am-11:00am/10:00am-1:00pm.
Job Title: School Cafeteria Food Service Aide
Job Summary: We are seeking dedicated individuals to join SOS Group as School Cafeteria Food Service Aides. As a vital part of our school community, you will play a crucial role in ensuring the smooth and efficient operation of the cafeteria. Your primary responsibilities will include assisting in food preparation, serving meals, maintaining a clean and organized dining area, and providing excellent customer service to students and staff.
Responsibilities:
<ol>
<li>
Food Preparation:
</li>
</ol>
<ul>
<li>
Assist in the preparation of meals according to established recipes and portion sizes.
</li>
<li>
Follow food safety and sanitation guidelines to ensure the quality and safety of meals.
</li>
</ul>
<ol>
<li>
Meal Service:
</li>
</ol>
<ul>
<li>
Serve meals to students and staff in a courteous and efficient manner.
</li>
<li>
Monitor portion control to minimize waste and ensure all individuals receive appropriate servings.
</li>
</ul>
<ol>
<li>
Cleanliness and Organization:
</li>
</ol>
<ul>
<li>
Maintain a clean and sanitized work environment, including kitchen and dining areas.
</li>
<li>
Clean and sanitize utensils, dishes, and equipment regularly.
</li>
<li>
Dispose of waste and ensure proper recycling procedures are followed.
</li>
</ul>
<ol>
<li>
Team Collaboration:
</li>
</ol>
<ul>
<li>
Work collaboratively with other cafeteria staff to ensure a cohesive and efficient operation.
</li>
<li>
Communicate effectively with kitchen and cafeteria personnel.
</li>
</ul>
Qualifications:
<ul>
<li>
Minimum of a high school diploma or equivalent.
</li>
<li>
State and Federal Background checks required.
</li>
<li>
Excellent communication and interpersonal skills.
</li>
<li>
Ability to lift up to 50 pounds.
</li>
<li>
Physically capable of standing for extended periods and moving quickly if necessary.
</li>
</ul>

Food Service Aide Substitute

Job Position: Part Time/Substitute School Food Service Aides.
Location: Norristown Area School District.
Pay Rate: $16.75/ Hour.
Shift: Work: Various Shifts, 3-4 hours a day. 9:15am-2:15pm / As needed
Job Title: School Cafeteria Food Service Aide
Job Summary: We are seeking dedicated individuals to join SOS Group as School Cafeteria Food Service Aides. As a vital part of our school community, you will play a crucial role in ensuring the smooth and efficient operation of the cafeteria. Your primary responsibilities will include assisting in food preparation, serving meals, maintaining a clean and organized dining area, and providing excellent customer service to students and staff.
Responsibilities:
<ol>
<li>
Food Preparation:
</li>
</ol>
<ul>
<li>
Assist in the preparation of meals according to established recipes and portion sizes.
</li>
<li>
Follow food safety and sanitation guidelines to ensure the quality and safety of meals.
</li>
</ul>
<ol>
<li>
Meal Service:
</li>
</ol>
<ul>
<li>
Serve meals to students and staff in a courteous and efficient manner.
</li>
<li>
Monitor portion control to minimize waste and ensure all individuals receive appropriate servings.
</li>
</ul>
<ol>
<li>
Cleanliness and Organization:
</li>
</ol>
<ul>
<li>
Maintain a clean and sanitized work environment, including kitchen and dining areas.
</li>
<li>
Clean and sanitize utensils, dishes, and equipment regularly.
</li>
<li>
Dispose of waste and ensure proper recycling procedures are followed.
</li>
</ul>
<ol>
<li>
Team Collaboration:
</li>
</ol>
<ul>
<li>
Work collaboratively with other cafeteria staff to ensure a cohesive and efficient operation.
</li>
<li>
Communicate effectively with kitchen and cafeteria personnel.
</li>
</ul>
Qualifications:
<ul>
<li>
Minimum of a high school diploma or equivalent.
</li>
<li>
State and federal Background checks required.
</li>
<li>
Excellent communication and interpersonal skills.
</li>
<li>
Ability to lift up to 50 pounds.
</li>
<li>
Physically capable of standing for extended periods and moving quickly if necessary.
</li>
</ul>

Job Position: Food Service Aides.
Location: Oley Valley School District.(Middle School)
Pay Rate: $14.00/ Hour.
Shift: Monday - Friday 10:00am-1:30pm
Job Title: School Cafeteria Food Service Aide
Job Summary: We are seeking dedicated individuals to join SOS Group as School Cafeteria Food Service Aides. As a vital part of our school community, you will play a crucial role in ensuring the smooth and efficient operation of the cafeteria. Your primary responsibilities will include assisting in food preparation, serving meals, maintaining a clean and organized dining area, and providing excellent customer service to students and staff.
Responsibilities:
<ol>
<li>
Food Preparation:
</li>
</ol>
<ul>
<li>
Assist in the preparation of meals according to established recipes and portion sizes.
</li>
<li>
Follow food safety and sanitation guidelines to ensure the quality and safety of meals.
</li>
</ul>
<ol>
<li>
Meal Service:
</li>
</ol>
<ul>
<li>
Serve meals to students and staff in a courteous and efficient manner.
</li>
<li>
Monitor portion control to minimize waste and ensure all individuals receive appropriate servings.
</li>
</ul>
<ol>
<li>
Cleanliness and Organization:
</li>
</ol>
<ul>
<li>
Maintain a clean and sanitized work environment, including kitchen and dining areas.
</li>
<li>
Clean and sanitize utensils, dishes, and equipment regularly.
</li>
<li>
Dispose of waste and ensure proper recycling procedures are followed.
</li>
</ul>
<ol>
<li>
Team Collaboration:
</li>
</ol>
<ul>
<li>
Work collaboratively with other cafeteria staff to ensure a cohesive and efficient operation.
</li>
<li>
Communicate effectively with kitchen and cafeteria personnel.
</li>
</ul>
Qualifications:
<ul>
<li>
Minimum of a high school diploma or equivalent.
</li>
<li>
State and Federal Background checks required.
</li>
<li>
Excellent communication and interpersonal skills.
</li>
<li>
Ability to lift up to 50 pounds.
</li>
<li>
Physically capable of standing for extended periods and moving quickly if necessary.
</li>
</ul>

Established&nbsp;in 1865, the George Washington University Law School is the oldest law school in the nation’s capital. The Law School is accredited by the American Bar Association and is a charter member of the Association of American Law Schools. GW Law is an urban campus located in downtown DC’s Foggy Bottom neighborhood, near to a vibrant mix of museums, restaurants, government and international organizations, the White House, and more. Additional information about the Law School can be found at <a href="https://www.law.gwu.edu/" target="_blank">https://www.law.gwu.edu/</a>.
The George Washington University Law Library seeks a qualified librarian for its Assistant Director for Resource Management Services position to begin as early as September 1, 2023. The librarian in this position oversees the Resource Management Services operations, which comprises Acquisitions &amp; Continuing Resources, Cataloging &amp; Metadata, and Library Management Systems (e.g., OCLC, ILS). Resource Management Services provides operational management of workflow processes for physical and electronic materials to ensure that library materials are easily accessible for faculty and student use when searched for in the library's integrated library system.
The Law Library supports the curricular and teaching requirements of the Law School, the research and publication needs of the law faculty, and the study and research needs of the law students; and provides to the scholarly community at large access to a research collection of material about the law and its history. Additional information about the Law Library can be found at <a href="https://www.law.gwu.edu/library" target="_blank">https://www.law.gwu.edu/library</a>.
Please note that initially the librarian in this position will be required to work at the university's Foggy Bottom campus in Washington, DC; the ability to work remotely in the future will be assessed and determined by the supervisor in accordance with Law School and University policies.
Essential Duties and Responsibilities:
<ul>
<li>Supervises the Resource Management Services Division (comprising the following departments: Acquisitions &amp; Continuing Resources, Cataloging &amp; Metadata, and Library Management Systems), which includes coordinating workflow, training, and evaluation of staff, and oversight of personnel issues within the division</li>
<li>With the other assistant directors and under the supervision of the director, manages ongoing daily activities of the library</li>
<li>Coordinates with the director and other assistant directors in short- and long-range planning for the library, and takes a leading role in creating and implementing library guidelines and procedures</li>
<li>Acts in the stead of the director in his absence, either alone or in cooperation with the other assistant directors</li>
<li>Coordinates with other library departments in connection with Resource Management Services activities affecting those departments</li>
<li>Maintains oversight for the library's integrated system, and works with the library management systems librarian on priorities for technical support issues</li>
<li>Collaborates with librarians with responsibilities related to electronic resources to discuss and resolve problems, review updates, and enhancements affecting the library’s electronic resources</li>
<li>Participates in other university, law school, library activities and/or serves on professional association committees</li>
<li>Performs other duties as assigned</li>
</ul>
Minimum Qualifications:
<ul>
<li>Graduate degree in library or information science (e.g., MLS) from an ALA-accredited institution or completion of degree requirements by the time of appointment, and</li>
<li>A minimum of five years of post-graduate degree experience in resource management services with a broad knowledge of acquisitions and continuing resources, cataloging and/or metadata, and library management systems; strong managerial, problem-solving, project management, and communication and writing skills</li>
</ul>
Preferred Qualifications:
<ul>
<li>Leadership skills including ability to mentor and develop team members and to work effectively in a diverse workforce</li>
<li>Demonstrated broad vision, strategic thinking, collaborative decision-making, and coherent planning as a leader and manager in a rapidly changing environment</li>
<li>Supervisory experience in resource management services</li>
<li>Experience working with legal materials</li>
<li>Experience with OCLC and an integrated library system</li>
<li>Reading knowledge of one or more European languages</li>
<li>Demonstrated superior customer service skills</li>
<li>Demonstrated organizational and time management skills</li>
<li>Demonstrated attentiveness to detail</li>
<li>Demonstrated ability to work well independently and as part of a team</li>
</ul>
Application Procedure: Please complete an online application, available at <a href="https://www.gwu.jobs/postings/100096" target="_blank">https://www.gwu.jobs/postings/100096</a> , to include uploading a resume and cover letter and providing contact information for three professional references. Review of applications will begin August 17, 2023, and continue until the position is filled. Only complete applications will be considered.
Employment offers are contingent on the satisfactory outcome of a standard background screening.
The university is an Equal Employment Opportunity/Affirmative Action employer that does not unlawfully discriminate in any of its programs or activities on the basis of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity or expression, or on any other basis prohibited by applicable law.

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