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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)

Colgate University Second Shift Operations Supervisor Requisition Number: 2025S023Posting Full Time/Part Time: Full Time Division: $ATSDiv Department: Facilities Department Wage/Salary Range: $65,000 to $70,000 Department Statement: It is the mission of the Facilities Department at Colgate University to create the safest, cleanest, and most comfortable environment that further distinguishes Colgate University as a world-class educational institution. We work hard as part of a unified team, to make everyone who arrives on campus feel welcomed. “One team, one mission” The Facilities Department provides the physical environment, utilities, and facilities support services necessary to promote the educational and research activities of the university. To ensure quality service to our community, we provide strong coordination and communications between multi-functional groups and our customers, with a customer-oriented approach. Training and development of self-directed teams promotes a work environment that encourages employee initiative, engagement and development. This position oversees 2nd shift custodians, groundskeepers, and tradespeople, ensuring effective maintenance, regulatory compliance, and excellent service to the campus community. Key responsibilities include staff supervision, performance management, and maintaining accurate records. This role requires strong leadership, organizational, and communication skills. Accountabilities: 
<ul>
<li>Serves as the point of contact for campus departments needing after-hours support and ensures all assigned employees execute work properly, within relevant regulatory guidelines and with emphasis on safety and sustainability.</li>
<li>Ensures assigned employees are courteous and responsive and have positive interactions with campus stakeholders.</li>
<li>Accountable for maintaining appropriate documentation as assigned.</li>
<li>Accountable for continuous condition assessment and work inspections.</li>
<li>Responsible for the effective supervision of staff as assigned.</li>
<li>Ensures selection and hiring of high-quality employees; ensures appropriate distribution of work assignments and high quality of employee work product; ensures fair and accurate performance assessments and feedback to include identifying areas for professional development and documenting and conducting disciplinary measures, as needed.</li>
<li>Responsible for ensuring fair and accurate decisions regarding employment status (hire, promotion, salary increases, termination ); ensures the creation of effective opportunities and programs for employee mentoring, development and sustained performance.</li>
<li>Ensures smooth transitions between shifts and proper documentation of work completed or outstanding.</li>
<li>Coordinates with Campus Safety and/or environmental health and safety as needed.</li>
</ul>
 Professional Experience/Qualifications 
<ul>
<li>Minimum of 2 years of experience directly supervising staff is required.</li>
<li>Experience and familiarity of state, and federal OSHA rules and regulations related to facilities services required.</li>
<li>Must have the ability to provide direction and leadership to achieve goals in a timely manner.</li>
<li>The ability to manage multiple priorities and deadlines, model superior customer service skills, and creatively problem-solve is critical.</li>
<li>Proficiency in MS Word, Excel, internet applications and e-mail necessary.</li>
<li>Must have experience in implementing quality improvement processes and industry best practices.</li>
<li>Must possess excellent oral and written communication, conflict resolution, customer service, interpersonal and organizational skills.</li>
<li>Experience in estimating costs for budgeting and monitoring expenditures is required.</li>
<li>Must be capable of working collegially with a diverse group of constituents on a daily basis.</li>
</ul>
Preferred Qualifications 
<ul>
<li>Familiarity of work order and time entry systems is a plus.</li>
<li>Experience managing in a collective bargaining unit environment would be helpful.</li>
</ul>
 Education A high school diploma or equivalent is required. An Associate’s degree or higher, or Technical School degree is preferred. Other Information This position is deemed essential under the University’s Essential Personnel Policy. Work Schedule: Full time Monday through Friday 2:30 pm to 11:00 pm Job Open Date: 03/14/2025 Job Close Date: 8/9/2025 Open Until Filled Yes Special Instructions Summary To view the full job posting and apply for this position, go to: <a href="https://apptrkr.com/6372807" target="_blank">https://careers.colgate.edu/postings/6261</a> The University recognizes that equal employment opportunity can only be achieved through demonstrated leadership. It is the Policy of the University to recruit, employ, retain, promote, and train employees on the basis of merit, ability, and valid job qualifications without regard to any characteristics protected by applicable local, state or federal laws. CAMPUS CRIME REPORTING AND STATISTICS The Department of Campus Safety will provide upon request a copy of Colgate’s Annual Security and Fire Safety Report. This report includes statistics as reported to the United States Department of Education for the previous three years concerning reported: 1. crimes that occurred on-campus; in certain off-campus buildings or property owned or controlled by Colgate University; and on public property within, or immediately adjacent to and accessible from, the campus and 2. fires that occurred in student housing facilities. The report also includes institutional policies concerning campus security and fire safety, such as policies concerning sexual assault, life safety systems, and other related matters. You may access the report from the Clery Compliance web page at: <a href="https://www.colgate.edu/about/offices-centers-institutes/dean-college/campus-safety-staff/clery-compliance" target="_blank">https://www.colgate.edu/about/offices-centers-institutes/dean-college/campus-safety-staff/clery-compliance</a>. Printed copies of this report may be obtained upon request from the Department of Campus Safety via e-mail at <a href="mailto:cusafety@colgate.edu" target="_blank">cusafety@colgate.edu</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-43d16ab6a34baf45b0bc14118c9e03b4

Second Shift Operations Supervisor

Activity Coordinator (PACE) CalOptima CalOptima Health is seeking a highly motivated Activity Coordinator (PACE) to join our team. The Activity Coordinator for the Program of All-Inclusive Care for the Elderly (PACE) will be responsible for developing, coordinating and planning individual and group recreational activities for participants in CalOptima Health's PACE. The incumbent will monitor and revise activities to ensure participants' and program goals are met and aligned with applicable regulations. Position Information: 
<ul>
<li>Department: PACE- Clinic </li>
<li>Salary Grade: 305 - $55,966 - $83,949 ($26.91 - $40.3601) </li>
<li>Work Arrangement: Full Office **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<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. Coordinates, implements and overlooks the activity program; updates the activity calendar and works with various departments to ensure entertainment and classes are scheduled.</li>
<li>Coordinates the day center's social programming and activities, including communicating current events.</li>
<li>Collaborates with supervisor to oversee day floor activities.</li>
<li>Conducts initial, annual and periodic assessments for all participants.</li>
<li>Establishes attainable and measurable goals and schedules individualized recreational activities and social activities as part of the plan of care.</li>
<li>Communicates participant changes to team members and reports any concerns to the Interdisciplinary Team (IDT) as needed.</li>
<li>Records, signs and dates progress reports in the participant's medical record.</li>
<li>Explains activities and programming to participants and works with other therapists and primary care staff to enhance the day center experience of participants.</li>
<li>Builds relationships and coordinates with various community resources, including performances by community organizations and holiday celebrations. </li>
<li>Coordinates recreational and activity outings into the community where possible.</li>
<li>Participates in Quality Assurance (QA) activities as appropriate; leads participant discussions on PACE programming improvement.</li>
<li>Serves as a member of the IDT and attends staff meetings and participates in participant care planning.</li>
</ul>
</li>
</ul>
<ul>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in recreational therapy or a related field PLUS 2 years of experience providing services for the frail or elderly population within the last 5 years 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>CPR and First-Aid Certification required or must be obtained within six (6) months of date of hire.</li>
<li>Must successfully obtain the Activity Coordinator State certification within the first 90 days of hire required.</li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese) required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Experience in event planning or activity coordination.</li>
<li>Experience designing engaging activities for diverse groups with different interests and abilities. </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 more than 50 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=6374328&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/6374328" target="_blank">https://jobs.caloptima.org/jobs/activity-coordinator-pace-pace-garden-grove-california-united-states-230402a9-67de-410f-88b6-5e0e197dc484</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-7700ef9a0bdc61428dfa3577718cf1de

Activity Coordinator (PACE)

Sr. ServiceNow Analyst (ITS Analyst Sr) CalOptima CalOptima Health is seeking a highly motivated Sr. ServiceNow Analyst (ITS Analyst Sr) to join our team. The ITS Analyst Sr (Corporate Applications (ServiceNow)) will facilitate the coordination and integration of program related activities through vendor-supported corporate applications. The incumbent will define system scope, objectives and business requirements to meet user needs. The incumbent will assist business customers in making informed decisions regarding the development, configuration and functionality of various applications and provide technical consulting to end users on systems projects. The incumbent will provide coordination and services relevant to key functions of software supported by the Information Technology Services (ITS) department, which supports a variety of end users and software, usually provided by a third-party vendor. The incumbent will contribute to the support and maintenance of assigned applications and serve as a technical point-of-contact. Position Information: 
<ul>
<li>Department: ITS - Infrastructure </li>
<li>Salary Grade: 314 - $99,902 - $159,843 ($48.03 - $76.8476) </li>
<li>Work Arrangement: Full Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>70% - 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>Optimizes existing and develops new service catalog offerings and associated flows with a focus on continual improvement and automation.</li>
<li>Leverages Flow Designer to further mature the service catalog and migrates away from workflows.</li>
<li>Identifies inefficiencies to ultimately implement areas of automation.</li>
<li>Supports the design of custom catalog items; works with business partners and the Service Catalog manager and application owner for implementation.</li>
<li>Maintains an ongoing knowledge of the ServiceNow product, version upgrades, enhancements, new features, etc. </li>
</ul>
</li>
</ul>
<ul>
<li>25% - Technical Support
<ul>
<li>Processes core system configuration as well as day-to-day user requests and incidents.</li>
<li>Creates technical design, ServiceNow code and architecture, and works with key business units to build solutions and processes, supporting maintenance, continual service improvement, and new capabilities on the ServiceNow platform.</li>
<li>Provides technical guidance on existing workflows for streamlining and improved efficiency. </li>
</ul>
</li>
</ul>
<ul>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in information services or related field required PLUS 5 years of direct experience as a ServiceNow admin or application owner; 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>5 years of ITS technical application support experience required.</li>
<li>5 years of computer hardware and/or software troubleshooting techniques and system support required. </li>
</ul>
 Preferred Qualifications: 
<ul>
<li>ServiceNow Certified Implementation Specialist a plus.</li>
<li>ServiceNow Certified Application Developer a plus.</li>
<li>ITIL Certification is highly desirable. </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=6372541&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/6372541" target="_blank">https://jobs.caloptima.org/jobs/sr-servicenow-analyst-its-analyst-sr-505-city-parkway-west-california-united-states-0be25507-edbb-4b69-82f3-63ed5d658ae6</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-c7813acbb4eb9e41a5d8518b55927940

Sr. ServiceNow Analyst (ITS Analyst Sr)

Community Partner (Inside Medicare Sales) CalOptima CalOptima Health is seeking a highly motivated Community Partner (Inside Medicare Sales) to join our team. The Community Partner (Inside Medicare Sales) will perform telemarketing and appointment setting tasks associated with obtaining new members in the OneCare program by making outbound calls to prospective members, participating providers, community-based organizations and government agencies. The incumbent will assist in enrolling new members, which will include the explanation of the OneCare benefits and coordination of services regarding Medicare and Medi-Cal services for individuals within these populations. The incumbent will perform outreach activities and attend cultural events and fairs within Orange County in conjunction with the Sales and Marketing departments. The incumbent will facilitate appointment setting and enrollment activities with members and OneCare Community Partners in a timely, professional and courteous manner. Position Information: 
<ul>
<li>Department: OneCare Sales &amp; Marketing </li>
<li>Salary Grade: 306 - $58,205 - $90,217 ($27.98 - $43.3736) </li>
<li>Work Arrangement: Full Office </li>
</ul>
 Duties &amp; Responsibilities: 
<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>Provides assistance and education to potential members regarding OneCare program for enrollment purposes.</li>
<li>Prepares and conducts telemarketing presentations to potential members and community agencies.</li>
<li>Maintains documentation of member cases within the FACETS system.</li>
<li>Conducts targeted outreach and training to community-based organizations, health networks, vendors, members and providers.</li>
<li>Performs outreach to potential members and provides them with information about OneCare at cultural events and fairs. </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 3 years of experience working with the needs of persons with disabilities in an enrollment capacity required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed below may also be qualifying. </li>
<li>Valid driver's license and vehicle, an acceptable driving record and current auto insurance or other approved means of transportation, will be required for work away from the primary office 50% of the time or more.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>1 year of phone experience in a sales environment. </li>
<li>Experience in Medicare Sales as an agent or broker. </li>
<li>Experience working with people in a customer or member service capacity. </li>
<li>HMO, Medi-Cal/Medicaid and health services experience. </li>
<li>Contact informational systems experience. </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese).</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>Possession of an active California Department of Insurance (DOI) license required or must be obtained within 60 calendar days from the start date of employment. </li>
<li>DOI license renewal every 2 years is required. </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=6372564&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 22, 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/6372564" target="_blank">https://jobs.caloptima.org/jobs/community-partner-inside-medicare-sales-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-a301c61328f60e4ea08d226efa24dee8

Community Partner (Inside Medicare Sales)

Program Specialist, Sr. (Community Relations) CalOptima CalOptima Health is seeking a highly motivated an experienced Program Specialist Sr to join our team. The Program Specialist Sr for Community Relations will assist in the development, planning and execution of community relations strategies, communications and activities. The incumbent will work closely with the department director to support community engagement with key stakeholders, program development, implementation of special projects, large scale events and meetings with key stakeholders to support CalOptima Health initiatives. The incumbent is responsible for overseeing and leading leaderships' participation and administrative support for special events, projects and meetings led by CalOptima Health and our key community stakeholders. The incumbent will serve as a subject matter expert to team members with their outreach and education activities. The incumbent will interface and work collaboratively with internal staff, members and community stakeholders, and support other key CalOptima Health leaders and staff on related projects. The incumbent will update and support internal staff members and requests from internal departments and external stakeholders for meetings and presentations and will participate in community events. Integrity and the ability to maintain confidentiality are essential. Position Information: 
<ul>
<li>Department: Community Relations </li>
<li>Salary Grade: 309 - $68,015 - $108,824 ($32.70 - $52.3192) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>75% - 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>Facilitates the coordination of communication materials for CalOptima Health's leadership, including but not limited to, talking points, presentations and correspondence and to educate government and community officials regarding CalOptima Health's mission, strategic priorities, policy positions, projects, plans and other activities.</li>
<li>Participates and provides direct support with CalOptima Health's initiatives, large-scale events and other high-profile projects.</li>
<li>Serves as the subject matter expert to support team members with their outreach and education activities.</li>
<li>Serves as a liaison between Community Relations and various internal departments to coordinate their participation and support with internal and external events and meetings.</li>
<li>Tracks, monitors and provides updates for specific and/or ongoing projects, such as generating reports, logs, calendars, and mailings, developing and managing databases, and applying general business practices, as well as CalOptima Health policies and procedures.</li>
<li>Maintains confidential and sensitive information and files regarding management projects and policy.</li>
<li>Directs and assigns projects and/or tasks to appropriate staff, as needed. </li>
</ul>
</li>
<li>20% - 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>Oversees and coordinates email and telephone requests from leaders, internal departments and external stakeholders.</li>
<li>Oversees the department's database and inventory for outreach and education materials and supplies. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in political science, public policy, public administration, communications, health care administration or related field PLUS 3 years of work experience in community or public relations and/or project management required or 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>Valid driver's license and vehicle, or other approved means of transportation, an acceptable driving record, and current auto insurance will be required for work away from the primary office 10% of the time.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Experience working in community health, public affairs, communications, public health or related field</li>
<li>Strategic planning and project management 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=6374350&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/6374350" target="_blank">https://jobs.caloptima.org/jobs/program-specialist-sr-community-relations-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-643fc59b0146d245accf54a2ee8ed7c0

Program Specialist, Sr. (Community Relations)

Business Analyst (Claims) CalOptima CalOptima Health is seeking a highly motivated Business Analyst (Claims) to join our team. Under general supervision, the Business Analyst (Claims) will identify and design solutions within Claims Administration processes. The incumbent will interpret regulatory letters and memos to identify the impact on claims processes. The incumbent will be responsible for implementation of changes through project management, system configuration and User Acceptance Testing (UAT). The incumbent will work independently and perform more complex analytical and administrative responsibilities. The incumbent will exercise discretion and judgment and may coordinate a function and the work of others within the program or representing the program/project. Position Information: 
<ul>
<li>Department: Claims Administration </li>
<li>Salary Grade: 310 - $72,096 - $115,353 ($34.66 - $55.4582) </li>
<li>Work Arrangement: Full Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<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>Works in conjunction with the Claims Administration team, Contracting, Provider Relations, Coding Initiatives and/or Information Technology to implement benefit or process changes that impact system configuration due to federal and state notices.</li>
<li>Performs system research and testing to ensure regulatory, coding, contract updates and configuration changes produce expected results; ensures that all documentation accurately reflects the current status of changes and outstanding issues identified during testing.</li>
<li>Creates business user test scenarios and testing schedules, including time estimates and deadlines, monitors milestone completion, tracks all phases of testing and provides timely reporting of issues that impact the testing progress.</li>
<li>Communicates to the Claims Administration management team, training and staff regarding any system enhancements or changes, including any process deficiencies identified from claims look-back analysis and UAT.</li>
<li>Assists the Claims Administration management team in identifying training and development of desktop procedures and policies for the Medi-Cal and Medicare lines of business impacted by system and/or regulatory changes.</li>
<li>Provides analytical support and technical expertise on requests for information from executives, directors and other staff regarding claims.</li>
<li>Remains updated on state, federal and commercial health care environments, identifying impacts to CalOptima Health programs and claims processes utilizing MedLearn, Centers for Medicare &amp; Medicaid Services (CMS) Updates, Medi-Cal Provider Bulletins, Medi-Cal manuals and Industry Collaboration Effort (ICE).</li>
<li>Reviews ad-hoc analysis and generates reports as requested.</li>
<li>Collaborates with Claims Administration management process improvement, project management and Training Program Coordinator to identify process improvement opportunities.</li>
<li>Partners with trainer and Claims Administration management team to create or update document processes and procedures.</li>
<li>Serves as subject matter expert with end-to-end claims adjudication/processing.</li>
<li>Facilitates communication on claims related topics. </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, management or related field PLUS 2 years of both Medicare and Medi-Cal claims adjudication experience required, including experience with Current Procedural Terminology (CPT-4), Healthcare Common Procedure Coding System (HCPC) coding or International Classification of Diseases (ICD-10); 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>
</ul>
 Preferred Qualifications: 
<ul>
<li>N/A</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=6372575&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 22, 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/6372575" target="_blank">https://jobs.caloptima.org/jobs/business-analyst-claims-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-e67e1e573a7a6948a011a0304b064368

Business Analyst (Claims)

Intern (Community Relations) CalOptima CalOptima Health is seeking a highly motivated Intern (Community Relations) to join our team. The overall purpose and objective of the Intern (Community Relations) is to gain work experience in the field prior to graduating. This is an opportunity to utilize and apply the skills and knowledge learned in the classroom setting and apply it in the workforce. The incumbent will have the primary responsibility of handling department assigned projects, given a moderate degree of independence. The incumbent will frequently meet with supervisors to go over the status and progress of assignments. Under general supervision, the incumbent will assist the department's management team in a wide variety of duties. The incumbent works closely with the department manager to assist in community engagement with key stakeholders and program development and implementation of special projects, large scale events and meetings with key stakeholders to support CalOptima Health initiatives. The incumbent may assist with coordinating administrative support for special events, projects, and meetings, led by CalOptima Health and our key community stakeholders. The integrity and the ability to maintain confidentiality is essential. Position Information: 
<ul>
<li>Department: Community Relations </li>
<li>Salary Grade: 301 - $47,840 - $64,584 ($23.00 - $31.0500) </li>
<li>Work Arrangement: Full Office </li>
<li> The submission of ALL items are required for consideration for Fall 2025: 
<ul>
<li>Completion of application </li>
<li>Resume</li>
<li>A statement of interest on why you are interested in this internship position (2 pages maximum). </li>
<li>Two (2) letters of recommendation (one academic, one professional) will be required upon confirmation of minimum qualifications.</li>
</ul>
</li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>95% - Department 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>Assists with department related projects as assigned.</li>
<li>Meets deadlines and completes sub-tasks of projects assigned.</li>
<li>Participates in meetings with the supervisor to go over status and progress of work assigned.</li>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High school diploma or equivalent required PLUS enrollment in a college or university two- or four-year degree program, an accredited vocational institution or a graduate program.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>n/a</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=6372597&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 22, 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/6372597" target="_blank">https://jobs.caloptima.org/jobs/intern-community-relations-505-city-parkway-west-california-united-states-17213b2e-7e7b-48ea-8d15-7e271d33688f</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-051f37c273b22f4188a91f30a762adc1

Intern (Community Relations)

Music Library Specialist/Student Supervisor Amherst Campus Full Time JR6107 Amherst has taken a leadership role among highly selective liberal arts colleges and universities in successfully diversifying the racial, socio-economic, and geographic profile of its student body. The College is similarly committed to enriching its educational experience and its culture through the diversity of its faculty, administration and staff. Job Description: Amherst College invites applications for the Music Library Specialist/Student Supervisor position. The Music Library Specialist/Student Supervisor is a full-time, year-round position, starting at $22.37 per hour - commensurate with experience. The Music Library Specialist/Student Supervisor is responsible for managing the library services, operations, programs, and collections of the Music Library. The position provides quality customer service in all circulation, reserve, and reference activities; and effectively works with student assistants, and contributes to music collection development and selection. Participates fully as a member of the Access Services department. Collaborates with the other Access Services student supervisors to develop and maintain best practices &amp; policies for student employment in the department. Summary of Responsibilities: Music Library operations 
<ul>
<li>Supervises stack maintenance and undertakes reorganization projects in the Music Library </li>
<li>Contributes to music collection development and selection with the Arts &amp; Humanities Librarian and the Collection Development &amp; Acquisitions Librarian through the purchase of scores and the establishment and maintenance of standing orders and approval plans; consults with music faculty about collection needs </li>
<li>Collaborates with the Arts &amp; Humanities Librarian on goals and planning for services and policies in the Music Library </li>
<li>Collaborates with the Digital Initiatives and Web Services department on supporting digitization initiatives in the music collection </li>
<li>Maintains media stations, manages audio production and other multi-media equipment, and supports new digital media in the library and the instruction of students in their use. Collaborates with the Weekend Access Services Assistant to maintain and replace circulating equipment </li>
<li>Manages and helps rethink the space of the Music Library </li>
<li>Responds to users about overdue and billing notices generated by the online system relating to the Music Library collections </li>
<li>Coordinates signage, maintains supplies, and oversees maintenance of photocopiers and printers for the Music Library </li>
</ul>
 Music Library staffing 
<ul>
<li>Assumes responsibility for staffing the Music Library circulation desk </li>
<li>Creates and manages the Student Assistant schedule during the academic year and for breaks </li>
<li>Provides backup staffing when students aren't available </li>
<li>Provides responsive and inclusive service at the Music Library </li>
<li>Welcomes users, maintains borrower accounts, explains policies, and makes referrals to other library or campus departments as appropriate </li>
<li>Hires, trains, and supervises student assistants for the Music Library, ensuring that they understand and carry out library policies and procedures </li>
<li>Supports student desk attendants in resolving customer service issues in a user-focused, equitable way </li>
<li>Collaborates with the Access Services student supervisor team to coordinate training needs, ensure desk staffing, monitor the Access Services Supervisors' email inbox, and set attendance/behavior expectations for student employees in the department </li>
</ul>
 Processes print and electronic reserves for the Music department 
<ul>
<li>Solicits syllabi/reading lists from faculty and Academic Department Coordinators </li>
<li>Checks assigned journal articles and book chapters for availability from the Library's databases and on the web </li>
<li>Collects materials and delegates digitization, assuring quality of electronic copies </li>
<li>Enters bibliographic citations, stable links and PDF files into eReserve Plus database for each course requested </li>
<li>Creates print reserve collection, maintaining accurate course and material listings in library database </li>
<li>Communicates with faculty and Academic Department Coordinators for clarification, copyright, and other issues </li>
<li>Collaborates regularly with the Reserves Team to establish and update departmental workflows for reserve processing </li>
<li>Shares monitoring of and responding to messages in the reserves email account with the reserves team </li>
<li>Provides backup support for reserve processing in non-music disciplines </li>
</ul>
 Access Services Team 
<ul>
<li>Provides backup support at Frost Library to meet departmental needs </li>
<li>Attends regular department, library, division, and collegewide meetings </li>
<li>Creates a professional development plan and participates in service opportunities in consultation with supervisor </li>
<li>Maintains documentation for areas of responsibility </li>
</ul>
 Supports other library departmental initiatives 
<ul>
<li>Outside of peak reserve processing season, provides support to other library departmental projects </li>
</ul>
 Qualifications: Required 
<ul>
<li>Bachelor's Degree </li>
<li>1 year of work experience in an academic or research library </li>
<li>5 years of equivalent work experience in lieu of minimum education and related experience </li>
<li>Demonstrated knowledge of music and experience handling music-related material </li>
<li>Demonstrated exceptional customer service, including creative problem-solving and a commitment to equitable access </li>
<li>Demonstrated close attention to detail and organizational skills </li>
<li>Proficient computer skills and demonstrated ability to learn and apply new technologies to existing operations </li>
<li>Ability to independently manage multiple priorities and tasks </li>
<li>Ability to work closely and problem-solve with colleagues from all library departments, students, faculty, and staff </li>
<li>Strong verbal and written communication skills </li>
<li>Required reference and background checks </li>
</ul>
 Preferred 
<ul>
<li>1 year of supervisory experience, demonstrating evidence of interviewing, onboarding, scheduling, and planning the ongoing training of a team of workers </li>
<li>Bachelor's degree in music, or equivalent combination of education, training, or experience </li>
<li>1 year of experience working in a music library </li>
</ul>
 Amherst College is pleased to provide a comprehensive, highly competitive benefits package that meets the needs of staff and faculty and their families. Benefits are an important part of our overall compensation, so it is critical that you review all of the options to ensure it meets your total compensation requirements. Click here for<a href="https://apptrkr.com/get_redirect.php?id=6332761&amp;targetURL=https://www.amherst.edu/offices/human_resources/benefits" target="_blank"> Benefits Information</a>. Interested candidates are asked to submit a resume and cover letter online at<a href="https://apptrkr.com/get_redirect.php?id=6332761&amp;targetURL=https://amherst.wd5.myworkdayjobs.com/Amherst_Jobs" target="_blank"> https://amherst.wd5.myworkdayjobs.com/Amherst_Jobs</a>. Please be sure to upload all requested documents prior to clicking Submit. Applications cannot be revised once submitted. (Current employees and students should apply by clicking on the Jobs Hub icon from their Workday home screen) Review of applications will begin July 7th and will continue until the position is filled. Expected start date is early October 2025. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. To apply, visit <a href="https://apptrkr.com/6332761" target="_blank">https://amherst.wd5.myworkdayjobs.com/en-US/Amherst_Jobs/job/Amherst-Campus/Music-Library-Specialist-Student-Supervisor_JR6107</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-835e94f32626d34d8ed257e9555e49ba

Music Library Specialist/Student Supervisor

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

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