L.A. Care Health Plan
Customer Solution Center Appeals and Grievances Training Specialist II
L.A. Care Health Plan, Los Angeles, California, United States, 90079
Customer Solution Center Appeals and Grievances Training Specialist II
Job Category:
Customer Service Department:
CSC Training & Performance Location:
Los Angeles, CA, US, 90017 Position Type:
Full Time Requisition ID:
11885 Salary Range:
$77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan, serving more than 2 million members. Mission:
L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents. The Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II is primarily responsible for the overall training strategy across the department. This position designs and conducts training programs using established regulatory and departmental guidelines, provides ongoing training on the core processing system, A&G processing procedures, and works with the quality team on quality and performance guidelines. Duties
Applies knowledge and skills to build competencies for the design of training programs that will boost employee’s workplace performance. Conducts training for Customer Solution Center A&G team in customer service, product operations, and other work processes. Maintains documentation, including database/system updates, training agendas, and sign-in sheets. Works with key stakeholders to monitor error trends, productivity, and quality standards for the program. Conducts assessments after training to measure, record, and report feedback on training material and sessions. Reviews and recommends updates on policy and procedure critical to claims process. Performs other duties as assigned. Education Required
Bachelor's Degree in Business Administration or Healthcare Related Field. In lieu of degree, equivalent education and/or experience may be considered. Experience
Required: A minimum of 3 years of Managed Care, Medicaid, and Medicare experience. A minimum of 3 years of experience in design and delivery of training programs. Skills
Required: Strong understanding of learning principles and ability to demonstrate in classroom situations. Knowledge of CA regulatory guidelines, Medi-Cal guidelines, Medicare guidelines, NCQA requirements. Skilled in group facilitation and managing effective discussion. Strong organizational & analytical skills. Ability to conduct effective and engaging presentations in a variety of delivery settings. Must be a strong team player willing to work toward achieving team goals. Excellent written and verbal communications skills. Proficient using Word, Excel, Power Point and Access. Physical Requirements
Light Additional Information
This position requires work after hours, on weekends, and holidays, with a hybrid remote schedule and occasional flexibility in hours/shift. Salary Range Disclaimer:
The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including: Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program
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Job Category:
Customer Service Department:
CSC Training & Performance Location:
Los Angeles, CA, US, 90017 Position Type:
Full Time Requisition ID:
11885 Salary Range:
$77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan, serving more than 2 million members. Mission:
L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents. The Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II is primarily responsible for the overall training strategy across the department. This position designs and conducts training programs using established regulatory and departmental guidelines, provides ongoing training on the core processing system, A&G processing procedures, and works with the quality team on quality and performance guidelines. Duties
Applies knowledge and skills to build competencies for the design of training programs that will boost employee’s workplace performance. Conducts training for Customer Solution Center A&G team in customer service, product operations, and other work processes. Maintains documentation, including database/system updates, training agendas, and sign-in sheets. Works with key stakeholders to monitor error trends, productivity, and quality standards for the program. Conducts assessments after training to measure, record, and report feedback on training material and sessions. Reviews and recommends updates on policy and procedure critical to claims process. Performs other duties as assigned. Education Required
Bachelor's Degree in Business Administration or Healthcare Related Field. In lieu of degree, equivalent education and/or experience may be considered. Experience
Required: A minimum of 3 years of Managed Care, Medicaid, and Medicare experience. A minimum of 3 years of experience in design and delivery of training programs. Skills
Required: Strong understanding of learning principles and ability to demonstrate in classroom situations. Knowledge of CA regulatory guidelines, Medi-Cal guidelines, Medicare guidelines, NCQA requirements. Skilled in group facilitation and managing effective discussion. Strong organizational & analytical skills. Ability to conduct effective and engaging presentations in a variety of delivery settings. Must be a strong team player willing to work toward achieving team goals. Excellent written and verbal communications skills. Proficient using Word, Excel, Power Point and Access. Physical Requirements
Light Additional Information
This position requires work after hours, on weekends, and holidays, with a hybrid remote schedule and occasional flexibility in hours/shift. Salary Range Disclaimer:
The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including: Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program
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