Senior Automation Specialist

Covered California; Sacramento (CA); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Healthcare benefits

Retirement and savings

Work-life services

Leave benefits

Work-life balance

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

Are you interested in using your analytical skills to improve automated eligibility for Californians seeking health coverage? Join our Eligibility Automation team to serve as a program subject matter expert, working with internal and external partners to translate complex eligibility and enrollment rules into clear business and system requirements. In this role, you will help define system behaviors, analyze defects and issues, and support solutions that reduce manual work, improve accuracy, and enhance customer experience. If you are passionate about expanding access to health coverage and enjoy solving problems at the intersection of enrollment and eligibility, and technology in a collaborative environment, we encourage you to apply.

At Covered California, we recognize our employees are our most valuable asset. We have a variety of career fields that help make a difference in the lives of Californians, and we’re looking for talented and enthusiastic individuals to join our team! Learn more about why you should join the Policy, Eligibility, and Research Division.

Application Deadline: 9/14/2025 @ 11:59 pm PST

Required Documents: Application, Resume and Statement of Qualifications (SOQ)

Qualifications We’re Looking For:

• Experience interpreting and applying healthcare eligibility and enrollment requirements, preferably within Covered California, Medi-Cal, or other public health coverage programs, and translating policy into business or system requirements.
• Experience working with or supporting eligibility and enrollment system automation (e.g., CalHEERS or similar large-scale IT systems), including identifying defects, documenting system behaviors, and partnering with technical teams on solutions.
• Strong analytical and critical thinking skills, including the ability to analyze complex data, rules, and workflows; identify root causes; and develop clear, actionable recommendations.
• Demonstrated ability to lead and collaborate on cross-functional projects and workgroups while effectively managing competing priorities and deadlines and maintaining high-quality work in a fast-paced environment.
• Strong verbal communication and facilitation skills, including presenting complex information in an accessible way and supporting decision-making with leadership and stakeholders.

Minimum Qualifications for Health Program Specialist II:

• CalHR

Employee Benefits:

Covered California provides incredible benefits for our employees, including healthcare, retirement and savings, work-life services, leave benefits, and work-life balance. To learn more, visit https://hbex.coveredca.com/careers/benefits/.

Note:

• To apply to this position, review this advertisement and complete your application via CalCareers at: CalCareers
• Please send any questions regarding the application process and/or position to [e-mail]
• New to state civil service employees are typically hired at the minimum of the salary range