Appeals Resolution Specialist

SAN-Andreas-Regional-Cente; San Jose (CA); Hybrid; USD 80,000 - 110,000; Full time

Benefits offered by this job

Free medical coverage

Dental coverage

Vision coverage

CalPERS pension

403(b) retirement plan

Flexible spending accounts

Employee Assistance Program (EAP)

Paid education leave

Holiday and vacation time

Hybrid work options

Employee discounts

Job summary

San Andreas Regional Center is seeking a skilled appeals and complaints administrator to implement the Center’s vision under the Lanterman Act. The role focuses on managing and resolving appeals, complaints, and related hearings with independence and discretion.

You will collaborate with families, individuals served, staff, and external agencies to resolve issues and improve policy and procedure. A bachelor’s degree plus relevant experience is required, with opportunities for hybrid work and

Qualifications

• Bachelor’s degree in social work, public administration, or related field.
• Two years of increasingly responsible social work experience, including experience with Regional Center systems.
• Knowledge of Regional Center systems, developmental disabilities, and effective quality service delivery.
• Ability to independently plan and schedule work, provide oral and written presentations, and adapt to changing priorities.
• Ability to work effectively with individuals served, their families and representatives, colleagues, the community, and other agencies.
• Creative problem-solving ability and people management.

Responsibilities

• Oversee, support and provide direction to Service Coordinators, including providing critical feedback.
• Establish and maintain collaborative relationships with individuals served, families, regional center staff, and state agencies.
• Negotiate and mediate with individuals served and families to resolve disagreements and draft informal decisions.
• Prepare witnesses and secure exhibits for hearings and related proceedings.
• Draft and submit reports on factual findings and recommended resolutions of complaints.
• Maintain tracking systems to ensure compliance with requirements.

Skills

Regional Center Systems

Conflict Resolution

Oral & Written Presentations

People Management

Education

Bachelor’s degree in social work or related field

Job description

Description

Join San Andreas Regional Center – Where Every Role Matters.

San Andreas Regional Center (SARC) is one of 21 regional centers in California, funded by the State and rooted in the values of the Lanterman Act. As a community-based nonprofit, we are dedicated to supporting individuals with developmental disabilities in living full, independent, and inclusive lives.

Join a diverse, mission-driven team that is passionate about making a meaningful difference every day. If you care deeply about equity, advocacy, and social impact— SARC is the place for you.

Job Summary:

While maintaining good public relations and implementing the goals and vision of the Regional Center, this position is responsible for administering and resolving appeal and complaint requests in accordance with the provisions of the Lanterman Developmental Disabilities Servies Act, the Regional Center’s contract with the California Department of Developmental Services, and the policies of the Board of Directors. This job requires the individual to have an understanding of the Lanterman Developmental Disabilities Services Act and to apply independent discretion and judgement in all facets of services and appeals.

Essential Job Functions:

• Oversee, support and provide direction to Service Coordinators, including providing critical feedback.
• Establish and maintain collaborative, cooperative, and positive working relationships with individuals served, their families and representatives, regional center staff, the Office of Administrative Hearings, and the Department of Developmental Services.
• Knowledge of applicable laws, represent, or assist to represent, the Regional Center in some or all aspects of informal meetings, mediations, and/or appeal hearings in compliance with California Welfare & Institutions Code Section 4700 et al.
• Complete required forms and paperwork to set and maintain appeals with the Office of Administrative Hearings, including drafting and submitting appropriate requests, motions, and statements.
• Negotiate and mediate with individuals served, their families, and their representatives to resolve disagreements and prepare and draft informal decisions and mediation agreements.
• Prepare witnesses and secure and prepare all necessary exhibits for hearing.
• Investigate, or assist to investigate, allegations of improper activity or violations of the rights of individuals served by vendor service providers or Regional Center staff and contractors under W&IC § 4731 and the Regional Center Whistleblower Policy, in compliance with the Center’s contract with the Department.
• Draft and submit reports to the Executive Director or their designee regarding factual findings and recommended resolution of complaints of individuals served by vendor service providers or Regional Center staff and contractors under W&IC § 4731 and the Regional Center Whistleblower Policy.
• Maintain and update appropriate tracking systems and reports to ensure compliance with Regional Center, state, and federal requirements.
• Provide technical assistance, as required, in the preparation of notices of action in compliance with Center requirements and policies and with the Lanterman Act.
• Provide training to community, stakeholders, or Regional Center staff regarding appeals and complaints as requested.
• Assist with the analysis and reporting of appeals, hearings, and complaints to determine trends and recommendation of appropriate proactive changes to policy and procedure.
• Other duties as required

Supervision Exercised

Uses independent judgement to provide instructions to service coordinators, managers, or other staff regarding appeals, complaints and other essential functions of service coordinators’ day-to-day responsibilities. Acts as a resource to give direction to service coordinators.

We offer a competitive benefits package designed to support your health, well-being, and future.

Employees receive free medical coverage (yes, free for employees!), along with free dental and vision insurance for your dependents.

Our benefits include a CalPERS pension plan, offering rare, long-term financial security through a lifetime pension, excellent health benefits, and overall career stability. Additional benefits include a 403(b) retirement plan, flexible spending accounts, and an Employee Assistance Program (EAP).

You’ll also enjoy:

• Five days of paid education leave per fiscal year
• Vacation time, sick leave, 12 paid holidays and 2 floating holidays!
• Life insurance, with options for additional coverage
• Access to an employee discounts portal full of great deals
• We offer flexible work schedules and select hybrid positions, promoting a healthy and balanced work-life experience. And that’s just the beginning — explore the full list of benefits on our careers website! (**Benefits apply to eligible employees.)

Requirements

Education/Experience:

A bachelor’s degree in social work, public administration, or a related field and two years of increasingly responsible social work experience, including experience with Regional Center systems and programs for the developmentally disabled.

Special Skills and Knowledge:

• Knowledge of regional center systems and procedures, developmental disabilities, and effective quality service delivery.
• Possess the ability to independently plan and schedule work, provide oral and written presentations, and adjust to changing situations and priorities.
• Knowledge of the principles of effective and authentic professional communication and conflict resolution.
• The ability to work effectively, positively, and cooperatively with individuals served, their families and representatives, colleagues, the community, and other agencies.
• Creative problem-solving ability.
• People management.

Other:

Use of an automobile, possession of a valid driver’s license and proof of automobile liability insurance for the minimum amount prescribed by law, or the ability to provide for independent transportation.