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Claims Supervisor

Dac40c13 F637 421c 8b9b 900423b43e12 19000101 000001 · French Camp, CA, US, French Camp, CA; Placerville, CA, US, Placerville, CA; Modesto, CA, US, Modesto, CA · Remote · Active · $83,000–$123,000 / year · ADP Workforce Now Recruiting

Job facts

FieldValue
CompanyDac40c13 F637 421c 8b9b 900423b43e12 19000101 000001
TitleClaims Supervisor
Normalized title-
Department / team-
LocationFrench Camp, CA, United States
Work modelRemote / Remote
Employment type-
Salary$83,000–$123,000 / year
Statusactive
ATS providerADP Workforce Now Recruiting
Posted / first seen2026-06-03 / 2026-06-05
Changed / last seen2026-06-06 / 2026-06-06

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ATS provider jobsActive postings observed through ADP Workforce Now Recruiting.Open
Provider filtered searchThe same provider as a filtered job collection.Open
City jobsActive postings in French Camp.Open
Work model jobsActive Remote postings.Open
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Linked records

CompanyDac40c13 F637 421c 8b9b 900423b43e12 19000101 000001
Sourcebdb4759b-fafb-47c8-9851-64d8dcfc8e0a
ATS providerADP Workforce Now Recruiting

Description

The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. This is a remote position. Must reside in California, preferably in our service area. What You Will Be Doing: Under general supervision, the Claims Supervisor is responsible for providing oversight and coordinating the daily operations of claims production or claims adjustment and auditing functions in a manner that meets established turnaround, quality and production goals, and regulatory standards. Work is varied and minimally to moderately complex and requires a limited to moderate degree of discretion and independent judgment. Supervises Claims Analysts Essential Functions Plans and assigns work; monitors department workload to ensure mandated turnaround times are met; makes timely and effective adjustments. Identifies, monitors and analyzes appropriate metrics, including production, inventory and submission/billing patterns; develops timely and effective corrective action plans based on findings. Develops, implements and maintains department policies and procedures; makes recommendations for revisions; communicates changes to appropriate individuals in a timely and effective manner. Responds to and resolves or facilitates resolution of complex claims, appeals, provider disputes, and third-party liability cases. Assists with the development and implementation of department-related upgrades and enhancements of transaction system and other tools. Identifies, monitors and analyzes transaction system processing issues; corrects or escalates as required. Works closely with interdepartmental units to improve workflow and processes: identifies issues and opportunities; initiates meetings; resolves issues or makes recommendations as required. Prepares for and participates in regulatory audits: compiles audit packets, provides information, develops and monitors timely and effective corrective action plans. Executes and monitors business plans; assists in the development and monitoring of department budget. Identifies training needs and opportunities; develops and delivers routine and ad hoc department training. Promotes and maintains an environment that supports HPSJ’s strategy, vision, mission and values. Hires, supervises and retains a competent staff. What You Bring: Knowledge, Skills, Abilities and Competencies Required In-depth knowledge of: procedure coding and medical terminology, and their application in benefits; general medical policy benefits and exclusions; industry standard payment practices. In-depth knowledge of claims processing systems, including coding. Basic knowledge of claims administration metrics models. Basic knowledge of audit processes, and the ability to effectively implement and maintain them. Ability to read, interpret and apply complex written guidelines, instructions and other materials. Ability to develop, execute and monitor relevant business plans. Basic analytical skills. Decision quality: Makes good and timely decisions that keep the organization moving forward. Action oriented: Takes on new opportunities and tough challenges with a sense of urgency, high energy and enthusiasm. Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities. Directs work: Provides direction, delegates and removes obstacles to get work done. Plans and aligns: Plans and prioritizes work to meet commitments aligned with organization goals. Optimizes work processes: Knows the most effective and efficient process to get things done, with a focus on continuous improvement; can develop, implement and maintain processes. Ensures accountability: Holds self and others accountable to meet commitments. Drives results: Consistently achieves results, even under tough circumstances. Organizational savvy: Maneuvers comfortably through complex policy, process and people-related organizational dynamics. Being resilient: Rebounds from setbacks and adversity when facing difficult situations. Courage: Steps up to address difficult issues, says what needs to be said. Situational adaptability: Adapts approach and demeanor in real time to match the shifting demands of different situations. Strong oral and written communication skills with the ability to communicate with diverse individuals inside and outside of HPSJ. Good presentation skills. Strong facilitation, problem solving and conflict resolution skills. Strong interpersonal skills with the ability to maintain effective working relationships with diverse individuals inside and outside of HPSJ Ability to commit to and facilitate an atmosphere of collaboration and teamwork. Strong customer service skills. Demonstrated ability to articulate and support HPSJ’s vision, mission, values and strategy, integrate into management practices, and foster their manifestation among staff. Demonstrated ability to supervise staff in a manner that maximizes employee performance and business results. Ability to develop and deliver relevant and effective training and supporting materials. Intermediate skills in Word and Excel, including the ability to develop formulas and links. Basic mathematics skills. Ability to speak and be understood in English. Ability to handle confidential information with appropriate discretion. Preferred In-depth knowledge of regulations and procedures governing Medi-Cal and other state sponsored programs. In-depth knowledge of the principles and practices of managed care. What You Have: Education and Experience Required HS diploma. At least one year experience as a claim's supervisor in healthcare; or At least two years’ experience as a claims lead in healthcare; or At least four years progressively responsible experience in healthcare claims. Preferred Associate’s degree. Managed care experience. Licenses, Certifications Required None What You Will Get: HPSJ Perks: Robust and affordable medical coverage including HMO and PPO plan options Employee Wellness Program promoting physical, mental, and financial well-being Dental and vision plan with multiple provider choices Generous paid time off (accrue up to 3 weeks of PTO, 4 paid floating holidays, and 9 paid holidays) CalPERS retirement pension program, automatic employer-paid retirements contributions, plus a voluntary defined contribution plan Two flexible spending accounts (FSAs)for healthcare and dependent care expenses Employer-Paid Term Life and AD&D Insurance Employer-Paid Disability Insurance Employer-Paid Assistance Program (EAP) Health Advocacy to help you navigate medical care and benefits Voluntary supplemental benefits including medical, legal, identity theft protection Online discount mall Tuition reimbursement Remote work contingent on business needs and company guidelines A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do Physical Demands Work may require frequent sitting, standing, and walking, constant repetitive motion, frequent talking and listening, closeup and distance vision requirements. Some work may require occasional travel based on the responsibilities of the position and business needs and occasional handling materials up to 50 pounds. Emotional/Psychological Demands Ability to cope with a fast-paced work environment, working under pressure, dynamic priorities and deadlines, constant decision making, working irregular hours, emotional and sensitive situations. Work Environment Work may be performed in a remote, hybrid, or onsite setting depending on the requirements of the position and business needs. For roles performed remotely, employees are expected to maintain a secure, distraction-free workspace, and reliable internet connectivity consistent with company standards. Important Notice : The duties, qualifications, and physical and emotional requirements listed in this job description are not exhaustive. Health Plan of San Joaquin reserves the right to revise this job description at any time.

Full job record

Job ID26cb01d1a341f7fae3d7d8170907b22b2b86c4fb
Org IDcb9103da-589c-4b9a-b7bc-5c728bcae0c5
Source IDbdb4759b-fafb-47c8-9851-64d8dcfc8e0a
Board IDbdb4759b-fafb-47c8-9851-64d8dcfc8e0a
Provideradp_workforcenow
Provider Job Key586663
TitleClaims Supervisor
Normalized Title—
Statusactive
Activeyes
Location TextFrench Camp, CA, US, French Camp, CA; Placerville, CA, US, Placerville, CA; Modesto, CA, US, Modesto, CA
Department—
Team—
Employment Type—
Workplace Typeremote
Remote Policyremote
CountryUnited States
RegionCA
CityFrench Camp
Salary Raw83000.00 To 123000.00 (USD) Annually
Salary Min83,000
Salary Max123,000
Salary CurrencyUSD
Salary Periodyear
Source URLhttps://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=dac40c13-f637-421c-8b9b-900423b43e12&ccId=19000101_000001&lang=en_US&type=JS&jobId=586663&jwId=9201191940852_1
Apply URLhttps://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=dac40c13-f637-421c-8b9b-900423b43e12&ccId=19000101_000001&lang=en_US&type=JS&jobId=586663&jwId=9201191940852_1
First Seen At2026-06-05 03:02:26Z
Last Seen At2026-06-06 13:05:15Z
Last Checked At2026-06-06 13:05:15Z
Last Changed At2026-06-06 13:05:15Z
Inactive At—
Source Posted At2026-06-03 18:15:00Z
Source Updated At—
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Extensions
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Work is varied and minimally to moderately complex and requires a limited to moderate degree of discretion and independent judgment.</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>&nbsp;</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#212121;border:none windowtext 1.0pt;padding:0in;'>Supervises</span></strong></span></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Claims Analysts</span></li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>&nbsp;</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#212121;border:none windowtext 1.0pt;padding:0in;'>Essential Functions</span></strong></span></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Plans and assigns work; monitors department workload to ensure mandated turnaround times are met; makes timely and effective adjustments.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Identifies, monitors and analyzes appropriate metrics, including production, inventory and submission/billing patterns; develops timely and effective corrective action plans based on findings.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Develops, implements and maintains department policies and procedures; makes recommendations for revisions; communicates changes to appropriate individuals in a timely and effective manner.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Responds to and resolves or facilitates resolution of complex claims, appeals, provider disputes, and third-party liability cases.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Assists with the development and implementation of department-related upgrades and enhancements of transaction system and other tools.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Identifies, monitors and analyzes transaction system processing issues; corrects or escalates as required.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Works closely with interdepartmental units to improve workflow and processes: identifies issues and opportunities; initiates meetings; resolves issues or makes recommendations as required.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Prepares for and participates in regulatory audits: compiles audit packets, provides information, develops and monitors timely and effective corrective action plans.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Executes and monitors business plans; assists in the development and monitoring of department budget.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Identifies training needs and opportunities; develops and delivers routine and ad hoc department training.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Promotes and maintains an environment that supports HPSJ&rsquo;s strategy, vision, mission and values.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Hires, supervises and retains a competent staff.</span></li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#FF6600;border:none windowtext 1.0pt;padding:0in;'>&nbsp;</span></strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#FF6600;border:none windowtext 1.0pt;padding:0in;'>What You Bring:</span></strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#212121;border:none windowtext 1.0pt;padding:0in;'>Knowledge, Skills, Abilities and Competencies</span></strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>Required</span></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>In-depth knowledge of: procedure coding and medical terminology, and their application in benefits; general medical policy benefits and exclusions; industry standard payment practices.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>In-depth knowledge of claims processing systems, including coding.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Basic knowledge of claims administration metrics models.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Basic knowledge of audit processes, and the ability to effectively implement and maintain them.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Ability to read, interpret and apply complex written guidelines, instructions and other materials.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Ability to develop, execute and monitor relevant business plans.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Basic analytical skills.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Decision quality: Makes good and timely decisions that keep the organization moving forward.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Action oriented: Takes on new opportunities and tough challenges with a sense of urgency, high energy and enthusiasm.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Directs work: Provides direction, delegates and removes obstacles to get work done.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Plans and aligns: Plans and prioritizes work to meet commitments aligned with organization goals.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Optimizes work processes: Knows the most effective and efficient process to get things done, with a focus on continuous improvement; can develop, implement and maintain processes.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Ensures accountability: Holds self and others accountable to meet commitments.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Drives results: Consistently achieves results, even under tough circumstances.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Organizational savvy: Maneuvers comfortably through complex policy, process and people-related organizational dynamics.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Being resilient: Rebounds from setbacks and adversity when facing difficult situations.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Courage: Steps up to address difficult issues, says what needs to be said.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Situational adaptability: Adapts approach and demeanor in real time to match the shifting demands of different situations.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Strong oral and written communication skills with the ability to communicate with diverse individuals inside and outside of HPSJ.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Good presentation skills.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Strong facilitation, problem solving and conflict resolution skills.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Strong interpersonal skills with the ability to maintain effective working relationships with diverse individuals inside and outside of HPSJ</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Ability to commit to and facilitate an atmosphere of collaboration and teamwork.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Strong customer service skills.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Demonstrated ability to articulate and support HPSJ&rsquo;s vision, mission, values and strategy, integrate into management practices, and foster their manifestation among staff.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Demonstrated ability to supervise staff in a manner that maximizes employee performance and business results.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Ability to develop and deliver relevant and effective training and supporting materials.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Intermediate skills in Word and Excel, including the ability to develop formulas and links.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Basic mathematics skills.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Ability to speak and be understood in English.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Ability to handle confidential information with appropriate discretion.</span></li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>&nbsp;</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>Preferred</span></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>In-depth knowledge of regulations and procedures governing Medi-Cal and other state sponsored programs.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>In-depth knowledge of the principles and practices of managed care.</span></li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#FF6600;border:none windowtext 1.0pt;padding:0in;'>&nbsp;</span></strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#FF6600;border:none windowtext 1.0pt;padding:0in;'>What You Have:</span></strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#212121;border:none windowtext 1.0pt;padding:0in;'>Education and Experience</span></strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>Required</span></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>HS diploma.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>At least one year experience as a claim&#39;s supervisor in healthcare; or</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>At least two years&rsquo; experience as a claims lead in healthcare; or</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>At least four years progressively responsible experience in healthcare claims.</span></li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#212121;border:none windowtext 1.0pt;padding:0in;'>&nbsp;</span></strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>Preferred</span></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Associate&rsquo;s degree.</span></li><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\"><span style='font-family: \"Century Gothic\", sans-serif;'>Managed care experience.</span></li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;text-indent:3.0pt;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>&nbsp;</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#212121;border:none windowtext 1.0pt;padding:0in;'>Licenses, Certifications</span></strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>Required</span></p><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin: 0in; line-height: normal; font-size: 14px; font-family: Calibri, sans-serif; color: rgb(33, 33, 33); background: white;\">None</li></ul><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:15.6pt;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); font-size: 14px;'>&nbsp;</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style=\"font-size: 14px;\"><strong><span style='font-family:\"Century Gothic\",sans-serif;color:#FF6600;border:none windowtext 1.0pt;padding:0in;'>What You Will Get:</span></strong></span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;background:white;'><span style='font-family: \"Century Gothic\", sans-serif; color: rgb(33, 33, 33); border: 1pt windowtext; padding: 0in; font-size: 14px;'>&nbsp;HPSJ Perks:</span></p><div style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;' data-pasted=\"true\"><ul style=\"margin-bottom:0in;list-style-type: disc;\"><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Robust and affordable medical coverage including HMO and PPO plan options</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Employee Wellness Program promoting physical, mental, and financial well-being</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Dental and vision plan with multiple provider choices&nbsp;</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Generous paid time off (accrue up to 3 weeks of PTO, 4 paid floating holidays, and 9 paid holidays)</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>CalPERS retirement pension program, automatic employer-paid retirements contributions, plus a voluntary defined contribution plan</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Two flexible spending accounts (FSAs)for healthcare and dependent care expenses</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Employer-Paid Term Life and AD&amp;D Insurance</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Employer-Paid Disability Insurance</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Employer-Paid Assistance Program (EAP)&nbsp;</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Health Advocacy to help you navigate medical care and benefits&nbsp;</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Voluntary supplemental benefits including medical, legal, identity theft protection</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Online discount mall</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Tuition reimbursement&nbsp;</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>Remote work contingent on business needs and company guidelines</span></li><li style=\"margin: 0in 0in 8pt; font-size: 14px; font-family: initial;\"><span style='font-family: \"Century Gothic\", sans-serif; color: black;'>A chance to work for an organization that is mission-driven &ndash; our members and community are at the core of everything we do</span></li></ul></div><p><br></p><p><br></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:justify;' data-pasted=\"true\"><strong><u><span style='font-size:13px;font-family:\"Century Gothic\",sans-serif;'>Physical Demands</span></u></strong></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:justify;'><span style='font-size:13px;font-family:\"Century Gothic\",sans-serif;'>Work may require frequent sitting, standing, and walking, constant repetitive motion, frequent talking and listening, closeup and distance vision requirements. Some work may require occasional travel based on the responsibilities of the position and business needs and occasional handling materials up to 50 pounds.</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:justify;'><strong><u><span style='font-size:13px;font-family:\"Century Gothic\",sans-serif;'>Emotional/Psychological Demands</span></u></strong></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:justify;'><span style='font-size:13px;font-family:\"Century Gothic\",sans-serif;'>Ability to cope with a fast-paced work environment, working under pressure, dynamic priorities and deadlines, constant decision making, working irregular hours, emotional and sensitive situations.&nbsp;</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:justify;'><br></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:justify;'><strong><u><span style='font-size:13px;font-family:\"Century Gothic\",sans-serif;'>Work Environment</span></u></strong></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:justify;'><span style='font-size:13px;font-family:\"Century Gothic\",sans-serif;'>Work may be performed in a remote, hybrid, or onsite setting depending on the requirements of the position and business needs. For roles performed remotely, employees are expected to maintain a secure, distraction-free workspace, and reliable internet connectivity consistent with company standards.</span></p><p style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;font-size:11.0pt;font-family:\"Calibri\",sans-serif;text-align:justify;'><em><u><span style='font-size:13px;font-family:\"Century Gothic\",sans-serif;'>Important Notice</span></u></em><em><span style='font-size:13px;font-family:\"Century Gothic\",sans-serif;'>: The duties, qualifications, and physical and emotional requirements listed in this job description are not exhaustive. Health Plan of San Joaquin reserves the right to revise this job description at any time.</span></em></p></div>\n",
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}
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