As a Program Assistant, you will be the central hub for our GARS department. Your primary responsibility will be managing the intake of all member and provider cases, meticulously monitoring our mail, fax, and digital channels. You will accurately enter and classify cases into our system, ensuring they are assigned to the appropriate staff for timely resolution in compliance with state and federal regulations.
Serving as a key point of contact, you will field inquiries and collaborate with internal teams and external providers to gather essential information. You will also play a crucial role in generating acknowledgment letters and providing administrative support for state hearings, upholding our commitment to regulatory compliance and high-quality performance.
What You'll Bring:
- A High School diploma or equivalent.
- At least one year of experience with appeal and grievance guidelines or Medi-Cal/Medicaid/Medicare programs.
- bilingual ability in English and one of the following is highly preferred: Arabic, Chinese, Farsi, Korean, Spanish, or Vietnamese.
This is a full-time, temporary position based in our office. The work schedule is Monday to Friday, 8:00 a.m. to 5:00 p.m., with a competitive salary range of $49,754 - $69,655 ($23.92 - $33.48/hour).
Ready to make an impact? Apply today!
salary: $23.92 - $33.49 per hour
shift: First
work hours: 8 AM - 4 PM
education: High School
Responsibilities
- 80% - Program Support
- Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
- Serves as the point of contact within or outside CalOptima Health for inquiries related to grievances and appeals.
- Monitors incoming complaints via the Customer Service system routing, interdepartmental referral, mail, telephone, fax or via email from the website for members and providers.
- Monitors inquiry requests from the Department of Managed Health Care (DMHC), Medicare Complaint Tracking Module (CTM) from the Centers for Medicare Medicaid Services (CMS), Medicare Quality Improvement Organization (QIO) and the State Hearing Office from Department of Social Services (DSS).
- Responds to DMHC requests for information in a timely manner.
- Sets up complaint case files, enters cases in the GARS system with accurate classification and category types and assigns them to appropriate staff.
Skills
Qualifications
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.
