County of Contra Costa
Manager of Member Services
County of Contra Costa, California, Missouri, United States, 65018
Overview
The Contra Costa County Health Services Department is offering a permanent full-time Manager of Member Services position in the Contra Costa Health Plan (CCHP) located in Martinez, CA. The Manager of Member Services is responsible for planning, coordinating, and managing the operational components of the member grievance and appeal process; implementing new legislation and regulations related to member services; and overseeing staff development for managed care. Other duties include providing day-to-day work direction, management and supervision of the Member Services unit and staff; conducting quarterly internal audits to ensure complaints meet strict regulatory guidelines; developing and implementing all activities involved in the member retention program; submitting monthly, quarterly, and annual reports as required by the State Department of Health Services; and facilitating the resolution of complex member inquiries. Responsibilities
Performing complex administrative work for the Member Services units of the Contra Costa Health Plan (CCHP) Developing and implementing all activities involved in the member retention program Providing day-to-day work direction, management and supervision to the member services unit and staff Facilitating the resolution of complex member inquiries, complaints, grievances, and appeals including formal investigations and, if necessary, referrals to a third party Implementing or modifying department goals and policies as needed to be compliant with legislative requirements Conducting quarterly internal audits to ensure complaints meet strict regulatory guidelines Submitting monthly, quarterly, and annual reports as required by the State Department of Health Service Qualifications you are looking for
Strong management and problem-solving skills Excellent interpersonal skills Strong skills with internal audits The ability to respond effectively to appeals Great analytical skills to facilitate required change Strong organizational skills and is priority driven Desirable Qualifications
Experience with electronic health records - Epic Knowledge of local community resources and programs Experience working with DSNP populations Education and Experience
Education:
Possession of a Bachelor's degree from an accredited college or university with a major in Business Administration, Public Administration, Marketing, or a closely related field. Experience:
Three (3) years of full-time or its equivalent administrative experience in a health care/health insurance setting with responsibility for member services, marketing, public relations, provider relations or another major program area. One (1) year of the required experience must have been as a supervisor and/or lead. Substitution for Experience:
Possession of a Master's degree from an accredited college or university with a major in Business Administration, Public Administration, Marketing, or a closely related field may be substituted for one year of experience. Substitution for Education: (1) One additional year of qualifying experience may be substituted for the required academic major. (2) Associate degree and two additional years of qualifying experience may be substituted for the required education on a year for year basis up to a maximum of two (2) years. Additional Information
Application Filing and Evaluation : Applicants will be required to complete a supplemental questionnaire at the time of application; applications will be evaluated to determine which candidates will move forward in the next phase of the recruitment process. Remote Oral Assessment : Candidates who possess the minimum qualifications will be invited to participate in an online oral assessment. The assessment will measure candidates' competencies as they relate to the job. In the assessment, candidates must achieve an average passing score of 70% or higher on each of the competencies, as well as an overall passing score of 70% or higher. These may include but are not limited to: Analyzing & Interpreting Data, Coaching & Developing Others, Action & Results Focused (Taking Initiative), and Leadership. TENTATIVE DATES Remote Oral Assessment: February 2-8, 2026 The examination steps noted above may be changed in accordance with the County’s Personnel Management Regulations and accepted selection practices. For recruitment questions, please contact Health Services Personnel, Recruitment Team at
Exams@cchealth.org . For any technical issues, please contact the Government Jobs’ applicant support team for assistance at +1 855-524-5627. CONVICTION HISTORY After you receive a conditional job offer, you will be fingerprinted, and your fingerprints will be sent to the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI). The resulting report of your conviction history (if any) will be used to determine whether the nature of your conviction conflicts with the specific duties and responsibilities of the job for which you have received a conditional job offer. If a conflict exists, you will be asked to present any evidence of rehabilitation that may mitigate the conflict, except when federal or state regulations bar employment in specific circumstances. Having a conviction history does not automatically preclude you from a job with Contra Costa County. If you accept a conditional job offer, the Human Resources department will contact you to schedule a fingerprinting appointment. DISASTER SERVICE WORKER All Contra Costa County employees are designated Disaster Service Workers through state and local law. Employment with the County requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency. EQUAL EMPLOYMENT OPPORTUNITY It is the policy of Contra Costa County to consider all applicants for employment without regard to race, color, religion, sex, national origin, ethnicity, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition, genetic information, military or veteran status, or other protected category under the law.
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The Contra Costa County Health Services Department is offering a permanent full-time Manager of Member Services position in the Contra Costa Health Plan (CCHP) located in Martinez, CA. The Manager of Member Services is responsible for planning, coordinating, and managing the operational components of the member grievance and appeal process; implementing new legislation and regulations related to member services; and overseeing staff development for managed care. Other duties include providing day-to-day work direction, management and supervision of the Member Services unit and staff; conducting quarterly internal audits to ensure complaints meet strict regulatory guidelines; developing and implementing all activities involved in the member retention program; submitting monthly, quarterly, and annual reports as required by the State Department of Health Services; and facilitating the resolution of complex member inquiries. Responsibilities
Performing complex administrative work for the Member Services units of the Contra Costa Health Plan (CCHP) Developing and implementing all activities involved in the member retention program Providing day-to-day work direction, management and supervision to the member services unit and staff Facilitating the resolution of complex member inquiries, complaints, grievances, and appeals including formal investigations and, if necessary, referrals to a third party Implementing or modifying department goals and policies as needed to be compliant with legislative requirements Conducting quarterly internal audits to ensure complaints meet strict regulatory guidelines Submitting monthly, quarterly, and annual reports as required by the State Department of Health Service Qualifications you are looking for
Strong management and problem-solving skills Excellent interpersonal skills Strong skills with internal audits The ability to respond effectively to appeals Great analytical skills to facilitate required change Strong organizational skills and is priority driven Desirable Qualifications
Experience with electronic health records - Epic Knowledge of local community resources and programs Experience working with DSNP populations Education and Experience
Education:
Possession of a Bachelor's degree from an accredited college or university with a major in Business Administration, Public Administration, Marketing, or a closely related field. Experience:
Three (3) years of full-time or its equivalent administrative experience in a health care/health insurance setting with responsibility for member services, marketing, public relations, provider relations or another major program area. One (1) year of the required experience must have been as a supervisor and/or lead. Substitution for Experience:
Possession of a Master's degree from an accredited college or university with a major in Business Administration, Public Administration, Marketing, or a closely related field may be substituted for one year of experience. Substitution for Education: (1) One additional year of qualifying experience may be substituted for the required academic major. (2) Associate degree and two additional years of qualifying experience may be substituted for the required education on a year for year basis up to a maximum of two (2) years. Additional Information
Application Filing and Evaluation : Applicants will be required to complete a supplemental questionnaire at the time of application; applications will be evaluated to determine which candidates will move forward in the next phase of the recruitment process. Remote Oral Assessment : Candidates who possess the minimum qualifications will be invited to participate in an online oral assessment. The assessment will measure candidates' competencies as they relate to the job. In the assessment, candidates must achieve an average passing score of 70% or higher on each of the competencies, as well as an overall passing score of 70% or higher. These may include but are not limited to: Analyzing & Interpreting Data, Coaching & Developing Others, Action & Results Focused (Taking Initiative), and Leadership. TENTATIVE DATES Remote Oral Assessment: February 2-8, 2026 The examination steps noted above may be changed in accordance with the County’s Personnel Management Regulations and accepted selection practices. For recruitment questions, please contact Health Services Personnel, Recruitment Team at
Exams@cchealth.org . For any technical issues, please contact the Government Jobs’ applicant support team for assistance at +1 855-524-5627. CONVICTION HISTORY After you receive a conditional job offer, you will be fingerprinted, and your fingerprints will be sent to the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI). The resulting report of your conviction history (if any) will be used to determine whether the nature of your conviction conflicts with the specific duties and responsibilities of the job for which you have received a conditional job offer. If a conflict exists, you will be asked to present any evidence of rehabilitation that may mitigate the conflict, except when federal or state regulations bar employment in specific circumstances. Having a conviction history does not automatically preclude you from a job with Contra Costa County. If you accept a conditional job offer, the Human Resources department will contact you to schedule a fingerprinting appointment. DISASTER SERVICE WORKER All Contra Costa County employees are designated Disaster Service Workers through state and local law. Employment with the County requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency. EQUAL EMPLOYMENT OPPORTUNITY It is the policy of Contra Costa County to consider all applicants for employment without regard to race, color, religion, sex, national origin, ethnicity, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition, genetic information, military or veteran status, or other protected category under the law.
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