Lead Eligibility Automation Specialist
Covered California
14 days+
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Benefits offered by this job
Job summary
Covered California is seeking a Health Program Specialist II to enhance automated eligibility for health coverage. The candidate will act as a subject matter expert, analyzing complex eligibility rules and translating them into business requirements. The role requires strong analytical skills, experience with system automation, and the ability to lead cross-functional projects. Employee benefits include healthcare, retirement options, and work-life balance initiatives. Interested applicants should apply by 9/14/2025.
Qualifications
- Experience interpreting and applying healthcare eligibility and enrollment requirements.
- Experience with CalHEERS or similar large-scale IT systems.
- Ability to analyze complex data and develop actionable recommendations.
- Demonstrated ability to lead and collaborate on projects in a fast-paced environment.
- Strong verbal communication skills to present complex information.
Responsibilities
- Work as a program subject matter expert for eligibility automation.
- Translate complex eligibility rules into clear business/system requirements.
- Analyze defects and issues, support solutions that enhance customer experience.
Skills
Experience interpreting healthcare eligibility
Experience with eligibility and enrollment system automation
Strong analytical and critical thinking skills
Ability to lead cross-functional projects
Strong verbal communication and facilitation skills
Job description
Covered California is seeking a Health Program Specialist II to enhance automated eligibility for health coverage. The candidate will act as a subject matter expert, analyzing complex eligibility rules and translating them into business requirements. The role requires strong analytical skills, experience with system automation, and the ability to lead cross-functional projects. Employee benefits include healthcare, retirement options, and work-life balance initiatives. Interested applicants should apply by 9/14/2025.
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