State of California
Job Summary
$6,031.00 - $7,547.00 per Month
(salary range)
Under the direction of the Initial Review Unit (IRU) Supervisor I, the Initial Review Lead Analyst will act in a lead capacity as a subject matter expert, responsible for performing case audits, screening, analyzing, and triaging Independent Medical Review (IMR) Applications and incoming complaints against Knox‑Keene licensed health, dental, vision, mental health, and other specialized health plans.
Responsibilities include implementing, monitoring, and evaluating health program activities, assessing and developing training materials within the Initial Review Section (IRS), and ensuring compliance with state health regulations.
Location & Work Arrangement Work locations: Downtown Sacramento and Rancho Cordova (both within easy reach of light rail). This position may be eligible for hybrid telework. Telework schedule is permitted at the operational needs of the Department and is subject to change, consistent with the State Telework Policy.
Minimum Requirements New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable. The position is temporary for the Personal Leave Program 2025 (PLP 2025) but the salary range remains unchanged.
Qualifications
Handles case audits, screening, analysis, and triage of IMR applications and complaints.
Develops and delivers training material for the Initial Review Section.
Demonstrated knowledge of health plan regulations and policies.
Effective communication skills with a customer‑service orientation.
Experience leading teams and managing a high‑volume caseload (desirable).
Ability to work independently, prioritize tasks, and resolve complex issues (desirable).
Proficiency with standard office software (Teams, Outlook, Word, Excel, PowerPoint).
Desirable Qualifications
Knowledge of health insurance principles, practices, and trends.
Experience in a fast‑paced, customer‑service‑oriented environment.
Excellent oral and written communication skills.
Capacity to cultivate collaborative working relationships.
Application Instructions Submissions must be received or postmarked by the Final Filing Date:
1/20/2026 .
Applicants may apply electronically via their CalCareer Account at www.CalCareers.ca.gov. Hard‑copy applications may be mailed or dropped off at the following address:
Department of Managed Health Care, DMHC Recruitment, Attn: Human Resources Office, 980 9th Street, Suite 500, Sacramento, CA 95814.
All required application materials include the State Examination/Employment Application (STD Form 678), resume (optional), and Statement of Qualifications (SOQ).
Contact Information Human Resources Contact: DMHC Recruitment (916) 322‑8437 Recruitment@dmhc.ca.gov
Hiring Unit Contact: Weda Thao (916) 255‑3894 Weda.Thao@dmhc.ca.gov
EEO Contact EEO Office (916) 738‑3394 EEO@dmhc.ca.gov
Equal Opportunity Employer The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
#J-18808-Ljbffr
(salary range)
Under the direction of the Initial Review Unit (IRU) Supervisor I, the Initial Review Lead Analyst will act in a lead capacity as a subject matter expert, responsible for performing case audits, screening, analyzing, and triaging Independent Medical Review (IMR) Applications and incoming complaints against Knox‑Keene licensed health, dental, vision, mental health, and other specialized health plans.
Responsibilities include implementing, monitoring, and evaluating health program activities, assessing and developing training materials within the Initial Review Section (IRS), and ensuring compliance with state health regulations.
Location & Work Arrangement Work locations: Downtown Sacramento and Rancho Cordova (both within easy reach of light rail). This position may be eligible for hybrid telework. Telework schedule is permitted at the operational needs of the Department and is subject to change, consistent with the State Telework Policy.
Minimum Requirements New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable. The position is temporary for the Personal Leave Program 2025 (PLP 2025) but the salary range remains unchanged.
Qualifications
Handles case audits, screening, analysis, and triage of IMR applications and complaints.
Develops and delivers training material for the Initial Review Section.
Demonstrated knowledge of health plan regulations and policies.
Effective communication skills with a customer‑service orientation.
Experience leading teams and managing a high‑volume caseload (desirable).
Ability to work independently, prioritize tasks, and resolve complex issues (desirable).
Proficiency with standard office software (Teams, Outlook, Word, Excel, PowerPoint).
Desirable Qualifications
Knowledge of health insurance principles, practices, and trends.
Experience in a fast‑paced, customer‑service‑oriented environment.
Excellent oral and written communication skills.
Capacity to cultivate collaborative working relationships.
Application Instructions Submissions must be received or postmarked by the Final Filing Date:
1/20/2026 .
Applicants may apply electronically via their CalCareer Account at www.CalCareers.ca.gov. Hard‑copy applications may be mailed or dropped off at the following address:
Department of Managed Health Care, DMHC Recruitment, Attn: Human Resources Office, 980 9th Street, Suite 500, Sacramento, CA 95814.
All required application materials include the State Examination/Employment Application (STD Form 678), resume (optional), and Statement of Qualifications (SOQ).
Contact Information Human Resources Contact: DMHC Recruitment (916) 322‑8437 Recruitment@dmhc.ca.gov
Hiring Unit Contact: Weda Thao (916) 255‑3894 Weda.Thao@dmhc.ca.gov
EEO Contact EEO Office (916) 738‑3394 EEO@dmhc.ca.gov
Equal Opportunity Employer The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
#J-18808-Ljbffr