Manager Customer Service, Covered CA Call Center
CalOptima
Join Us in this Amazing Opportunity
The Team You'll Join
We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.
More About the Opportunity
We are hoping you will join us as a Manager Customer Service, Covered CA Call Center and help shape the future of healthcare where you'll be an integral part of our Customer Service team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Full Office.
• If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.
The Manager Customer Service (Covered CA - Call Center) will manage and oversee the daily operations of all call center activities and staff. You'll address and resolve complex customer service questions and concerns for individual members, providers, special groups. Additionally, you'll provide information and education on member issues and maintain department standards. Finally, you'll oversee and ensure that call center staff effectively support members by providing information and directing cases to the appropriate operational teams. Together, we are building a stronger, more equitable health system.
Your Contributions To the Team:
• 50% - Leadership Functions
• Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department.
• Manages employees directly and is responsible for selecting, training, developing, reviewing and setting department and individual performance goals.
• Collaborates with the Director to implement strategies to improve operational performance, including call management and quality, average speed of answer, average handle time, abandonment rate and service levels.
• Partners closely with other department leadership (i.e., Grievance and Appeals, Medical Management) to implement and coordinate strategic and tactical plans to enhance operational service performance.
• Sets priorities and monitors individual and team performance by reviewing operational metrics, observing call management techniques for regulatory compliance, and providing frequent, ongoing feedback and coaching.
• Provides strategic input into forecasting and planning processes to ensure the call center meets all state and federal requirements.
• Establishes and maintains a collaborative relationship with internal and external business partners to ensure member and provider satisfaction.
• Adapts departmental plans and priorities to address business and operational challenges.
• Communicates changes such as policies, procedures and overall performance as a team and individually.
• Ensures staff communicate and follow through on performance management in accordance with CalOptima Health policies and practices.
• 45% - Customer Service Oversight
• Oversees customer service operations related to Covered California members, ensuring call center staff are trained and provide accurate information regarding enrollment, benefits and covered services.
• Collaborates with other departments, ensures all tools and resources provide proper direction for case handling/routing.
• Collaborates with Enrollment and Premium Billing teams to ensure accurate information is communicated to members regarding enrollment status, premium billing, grace periods and reinstatement process.
• Coordinates with internal leadership when Covered California or regulatory inquiries involve call center operations.
• Supports regulatory and audit requests related to call center operations, including call handling procedures and service metrics.
• Provides guidance and subject matter expertise regarding Covered California.
• Manages and leads department project assignments in a timely and effective manner.
• 5% - Other
• Completes other projects and duties as assigned.
Do You Have What the Role Requires?
• Bachelor's degree in business, healthcare administration or related field PLUS 5 years of leading health plan operations experience, including 2 years of experience in health insurance exchange/marketplace and/or commercial Individual and Family Plan (IFP) required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
• 3 years of progressive management/leadership experience, including direct supervision of staff required.
You'll Stand Out More If You Possess the Following:
• Experience at a health plan leading customer service functions for an exchange or commercial product.
• Experience with Covered California.
What the Regulatory Agencies Need You to Possess?
• N/A
Your Knowledge & Abilities to Bring to this Role:
• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Your Physical Requirements (With or Without Accommodations):
• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment less than 10 pounds
Ways We Are Here For You
• You'll enjoy competitive compensation for this role.
• Our current hiring range is: Pay Grade: 313 - $90,820 - $145,312 ($43.66 - $69.8615).
• The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors.
• This position is approved for Full Office (**If the position is Telework, it is eligible in California only**)
• A https://www.caloptima.org/en/careers#benefits
• CalPERS pension program and additional retirement packages.
• Additional benefits and perks including:
• A generous PTO program
• A quality work life balance
• Various wellness programs
• Tuition Reimbursement
• Professional development opportunities
• Career development opportunities
• Flexible scheduling
• And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.
Our Work Environment:
If located at the 500, 505 Building or a remote work location:
• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.
If located at PACE:
• Work is typically indoors in a clinical setting serving the frail and elderly.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.
If located in the Community:
• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• Employee will occasionally work outdoors in varied temperatures.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.
Why Join Us?
We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare.
What's Your Next Step?
All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is April 9, 2026 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.
Our Commitment to You
Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview.
If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process.
CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.
CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.
If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.
To apply, please visit: https://apptrkr.com/7037013
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