Special Projects Analyst

Covered California; California; Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health benefits

Vision benefits

Dental benefits

Retirement plan

Job summary

Covered California is seeking a Special Projects Analyst to join the CR&R Branch in Sacramento. The role focuses on reducing duplicate enrollment-related escalations and addressing financial inaccuracies related to subsidies, while supporting Appeals and Escalations Resolution.

You will leverage enrollment and CRM systems to resolve complex eligibility issues, applying research and strong communication to deliver timely, accurate results for financially vulnerable consumers.

Qualifications

• Experience handling escalations, appeals, or grievances in a call center.
• Experience managing multiple projects with competing priorities and deadlines.
• Experience interpreting regulations, government codes, policies, and procedures.
• Excellent verbal and written communication skills.
• Experience researching, analyzing and evaluating data and developing recommendations.
• Experience within the health care or health insurance industry.
• SOQ must address each question in numbered order.

Responsibilities

• Assist in reducing duplicate enrollment-related escalations across service channels.
• Support Appeals and Escalations Resolution (ER) efforts within CR&R Section.
• Utilize enrollment and CRM systems to resolve complex eligibility and enrollment issues.

Skills

Analytical thinking

Research skills

Customer service

Communication

Call center experience

Tools

CRM software

Job description

Join the Covered California team!

Who Are We?

The Consumer Relations and Resolution (CR&R) Branch is seeking a passionate analyst to join the Special Projects Unit (SPU). This position will focus on reducing duplicate enrollment-related escalations across service channels originating from consumers, carriers, counties, and advocacy groups. The role also addresses financial inaccuracies, including cases of overconsumption of subsidies, while performing cross-functional duties to support Appeals and Escalations Resolution (ER) within the CR&R Branch. Additionally, SPU supports various projects and collaborates with other Covered California divisions, such as Policy, Program Integrity, Plan Management, and Information Technology.

How Will I Make an Impact?

As a Special Projects Analyst, you will:

• Be part of a team that is responsible for helping some of Covered California’s most financially vulnerable consumers.
• Focus on utilizing multiple healthcare enrollment and customer relationship management (CRM) systems to resolve complex and in-depth eligibility and enrollment-related issues.
• Leverage your call-center experience and research skills to complete independent assignments and ensure swift and accurate resolution of time-sensitive assignments.

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 Service Center Division.

This position is headquartered in 1601 Exposition Blvd Sacramento, CA 95815. Business travel may be required, and reimbursement considers an employee’s designated headquarters office subject to regulations and bargaining unit contract provisions. Travel expenses associated with commuting to the employee’s office headquarters location are not reimbursable, other than authorized transit subsidies.

NOTE: To be considered for this job opportunity, applicants must be reachable on an employment list, have transfer eligibility, or have reinstatement eligibility. If you are new to California State Service and you do not have list eligibility, you must take the exam for this classification. To gain employment list eligibility, the Analyst I exam bulletin and the Analyst II exam bulletin.

Covered California does not provide visa sponsorship and is not an E-Verify employer.

Effective July 1, 2025, in response to the budget deficit, the Department of Human Resources (CalHR) has implemented the Personal Leave Program 2025 (PLP 2025). PLP 2025 requires that each full-time employee working their assigned work schedule receive a 3 percent reduction in pay in exchange for 5 hours of PLP 2025 leave credits monthly through June 30, 2027.

Working Conditions

This position may be eligible for telework. In accordance with Government Code section 14200, only employees who reside in California are eligible for telework. The amount of telework is at the discretion of the Department and based on Covered California’s current telework policy. While Covered California supports telework, in-person attendance may be required based on operational needs. Employees are expected to be able to report to their worksite with minimal notification if an urgent need arises, as determined by the Department.

Special Requirements

A Statement of Qualifications (SOQ) must discuss how your education, training, and experience qualifies you for this position. The SOQ must be no more than two pages in length, 12 pt. Arial font, and must address each question in numbered order corresponding to the questions listed below.

1. Describe how your previous work experience, edu cation, and/or training have prepared you to perform the duties of a Special Projects Analyst. Include examples demonstrating your ability to analyze information, conduct research, exercise sound judgment, resolve complex issues, and provide accurate and timely customer service.
2. Give us an example of a recent assignment or project you completed. Describe the process you used to ensure the work was complete, accurate, and in compliance with applicable laws, rules, policies, and procedures. What was the assignment, what did you do, and what was the outcome?
3. Describe a time when you did not have enough information to make a decision. What was the situation, how did the lack of information affect the situation, and what action did you take to mitigate potential negative impacts?

Desirable Qualifications

In addition to evaluating each candidate's relative ability, as demonstrated by quality and breadth of experience, the following factors will provide the basis for competitively evaluating each candidate:

2+ years of experience in the following areas:

1. Experience working on Escalations, Appeals, or Grievances in a call center environment.
2. Experience managing multiple projects with competing priorities and deadlines.
3. Experience interpreting regulations, government codes, policies, and procedures.
4. Excellent verbal and written communication skills, including documentation and presentation of findings.
5. Experience researching, analyzing and evaluating data and developing recommendations.
6. Experience within the health care or health insurance industry.

Benefits

The State of California offers a comprehensive benefits package that includes Health, Vision, Dental, Retirement, and an array of other options.

Pre-Employment Requirements

Background Check: All applicants shall be subject to a pre-employment background investigation. The investigation will consist of completion of a pre-employment questionnaire, fingerprinting, and an inquiry to the Department of Justice and Federal Bureau of Investigation to disclose criminal records.

Incompatible Activities: To maintain our integrity and focus on serving Californians, Covered California adheres to unique conflict of interest restrictions on the outside employment and activities of its board members and staff. If you’re considering a role with us, it’s important to know at the time of your start:

• You must not be employed by or otherwise affiliated with health insurance carriers, other insurers, agents, brokers, health care professionals, health facilities, or health clinics, or trade associations of any of these entities. This also means that you must not hold an active license to sell health insurance in California.
• You must not hold an active license to sell health insurance in California.
• Health care professionals are welcome to join our team, provided you do not receive payment for professional services and do not hold ownership or financial interests in a health care practice.

Required Application Package Documents

The following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:

• Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
• Resume is optional. It may be included, but is not required.
• Statement of Qualifications -
  • Please attach your SOQ to your application. Applications received without a SOQ may not be considered. Resumes and cover letters will not be accepted in place of a SOQ.