Grievance & Appeals Resolution Services at Orange, CA

#CNA2025



Program Assistant (GARS) 6-Month Contract

Location: Orange County, CA

Pay Rate: $23.92 $33.49 per hour

Schedule: Monday Friday, 8:00 a.m. 5:00 p.m.

Job Type: Full-Time, 6-Month Contract

About the Role

The facility is seeking a detail-oriented Program Assistant (Grievance & Appeals Resolution Services) for a 6-month contract. In this role, you will support the department by processing complaints, appeals, and state hearings while ensuring compliance with regulatory requirements. This is an on-site position based in Orange County, CA.

Responsibilities

• Process member and provider grievances and appeals.
• Monitor and log complaints received via phone, email, fax, and mail.
• Track and respond to inquiries from regulatory agencies (DMHC, CMS, DSS, QIO) within required timelines.
• Maintain accurate case files and prepare acknowledgment letters.
• Provide administrative support for hearings and departmental processes.
• Coordinate with internal teams and external stakeholders to ensure timely resolution.

Qualifications

• High School Diploma or equivalent required.
• At least 1 year of experience in grievance/appeals or Medi-Cal/Medicare programs.
• Strong communication, organizational, and problem-solving skills.
• Ability to work independently and meet deadlines.
• Preferred: Bilingual in one of CalOptima's threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese).

About CalOptima Health
CalOptima Health is Orange County's largest health plan, serving nearly one in four residents. We are committed to delivering quality healthcare with dignity, respect, and excellence in service.

Thanks & Regards,

Yashika
Sr. Healthcare Recruiter
Direct: 510-400-6494
Email: [email protected]

Aroha Technologies Inc.

5000 Hopyard Rd Suite - 415

Pleasanton, CA - 94588