Job Description

Join the Covered California team!

Are you someone who enjoys a fast-paced environment? We are looking for an Integrated Fraud Analyst responsible for evaluating consumer complaints and internally identified cases of fraud, waste, and abuse within our organization. Utilizing advanced data analytics techniques, the Analyst plays a crucial role in proactively identifying enrollment trends that could potentially indicate fraudulent activities. The position involves thorough analysis and assessment of complex data sets to swiftly detect patterns and anomalies, aiding in the prevention and mitigation of fraudulent activities. This role requires a keen eye for detail, analytical acumen, and the ability to work independently while collaborating effectively within a team environment.

The Program Integrity Division at Covered California is looking for an Integrated Fraud Analyst than can achieve the following:

• Research complaints
• Analyze and resolve problems presented to the unit
• Capture and analyze data
• Conduct phone interviews with consumers and enrollment partners
• Prepare, updates, and implements policies

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 Program Integrity Division

Salary:

$5,855.00 - $7,327.00 per Month

Application Deadline: 8/19/24 @ 11:59 pm PST

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

Qualifications We’re Looking For:

• Knowledge of mitigation of risks and fraud, policy and regulations, and the Affordable Care Act (ACA)
• Experience/knowledge of public health, healthcare industry services and programs
• Experience in researching, identifying, and timely resolving fraud trends as it relates to compliance, risk management, and fraud detection
• Ability to maintain positive and professional working relationships with internal and external partners to foster a positive work environment
• Excellent communication and writing skills, including demonstrated ability to communicate effectively to a wide range of audiences such as policyholders’, enrollees, healthcare providers, and internal team members
• Experience working with minimal supervision and ability to independently initiate recommendations to implement and accomplish goals and objectives

Minimum Qualifications for Associate Governmental Program Analyst:

Associate Governmental Program Analyst (5393) - 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

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 Careers@covered.ca.gov

New to state civil service employees are typically hired at the minimum of the salary range

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