Job Posting: Lead Appeals Analyst

Covered California

JC-526297
-
Lead Appeals Analyst
ANALYST II

$6,031.00 - $7,775.00 per Month
New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable.

Final Filing Date: 8/6/2026

Job Description and Duties

Join the Covered California team!


Are you a skilled problem-solver with a passion for navigating complex issues and delivering clear, actionable solutions? Covered California is looking for a Lead Appeals Analyst to join our Consumer Relations and Resolution team, where your expertise in resolving customer appeals, escalations, and administrative processes will make a real impact. This role offers the opportunity to leverage your experience in the insurance or healthcare industry, your knowledge of the Affordable Care Act, your talent and experience in researching customer issues, preparing well-crafted statements and recommendations, and your expertise in implementing effective resolution for identified issues. If you thrive in customer-facing environments, are familiar with using Customer Relationship Management (CRM) systems like Salesforce to maintain customer information, and are proficient with Microsoft Office applications, this position is your opportunity to excel while contributing to meaningful outcomes!

 

At Covered California, we recognize our employees are our most valuable asset. We have a variety of career fields that help make a difference in the lives of Californians, and we’re looking for talented and enthusiastic individuals to join our team! Learn more about why you should join the Service Center Division.

This position is headquartered in 1601 Exposition Blvd Sacramento, CA 95815. Business travel may be required, and reimbursement considers an employee’s designated headquarters office subject to regulations and bargaining unit contract provisions. Travel expenses associated with commuting to the employee’s office headquarters location are not reimbursable, other than authorized transit subsidies.

 

NOTE: To be considered for this job opportunity, applicants must be reachable on an employment list, have transfer eligibility, or have reinstatement eligibility. If you are new to California State service and you do not have list eligibility, you must take the exam for this classification. To gain employment list eligibility, please click here to access the Analyst II exam bulletin.

 

Possession of minimum qualifications will be verified prior to interview and/or appointment. If it is determined an applicant does not meet the minimum qualifications, the applicant's name may be removed from the eligibility list.

 

Covered California does not provide visa sponsorship and is not an E-Verify employer.

 

Effective July 1, 2025, in response to the budget deficit, the Department of Human Resources (CalHR) has implemented the Personal Leave Program 2025 (PLP 2025). PLP 2025 requires that each full-time employee working their assigned work schedule receive a 3 percent reduction in pay in exchange for 5 hours of PLP 2025 leave credits monthly through June 30, 2027. 

You will find additional information about the job in the Duty Statement.

Working Conditions

This position may be eligible for telework. In accordance with Government Code section 14200, only employees who reside in California are eligible for telework. The amount of telework is at the discretion of the Department and based on Covered California’s current telework policy. While Covered California supports telework, in-person attendance may be required based on operational needs. Employees are expected to be able to report to their worksite with minimal notification if an urgent need arises, as determined by the Department.

Minimum Requirements

You will find the Minimum Requirements in the Class Specification.

Additional Documents

Position Details

Job Code #:
JC-526297
Position #(s):
801-312-5393-700
Working Title:
Lead Appeals Analyst
Classification:
ANALYST II
$6,031.00 - $7,775.00
New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable.
# of Positions:
1
Work Location:
Sacramento County
Telework:
Hybrid
Job Type:
Permanent, Full Time
Work Shift:
8:00am - 5:00pm
Work Week:
M - F

Department Information

Covered California works to improve the health of all Californians by assuring their access to affordable, high quality healthcare. Our employees are the vital link that ensures that our vision, mission, and values are fully realized and are the driving force that allows us to continually provide exceptional service to those who need it most.

 

We offer an award-winning wellness program, inclusive and diverse atmosphere, employee recognition programs, on site fitness centers at our Sacramento and Service Center locations, and free parking at all of our locations!

 

Life can change in an instant – so can your career!

 

Visit our website to learn more about why Covered California is an employer of choice.

Special Requirements

Statement of Qualifications (SOQ) Instructions: A SOQ is required to apply. The SOQ will be used as a pre-interview screening tool. Applicants who do not follow the SOQ instructions and/or do not answer the prompt as stated below may not be considered.

 

Artificial Intelligence (AI) tools can be useful in the development of written responses; however, it is important to use these tools responsibly and ethically.  Where assistive tools may be used, responses within the SOQ should be your own original work.  Applicants must write in their own words and avoid plagiarism.  Failure to comply may be cause for disqualification.

 

A Statement of Qualifications (SOQ) must discuss how your education, training, and experience qualifies you for this position. The SOQ must be no more than two pages in length, 12 pt. Arial font, and must address each of the questions listed below.  

  1. Describe in detail a time when you used your analytical skills to solve a problem. Please answer each of the following:
    1. What was the problem?
    2. What options did you consider?
    3. How did you evaluate your options?
    4. What recommendations did you make?
    5. What was the outcome?
  2. Describe your experience communicating with internal and external customers. What are some essential tools for providing excellent customer service? Please provide an example.
  3. Describe your experience applying and communicating policy, regulations, and/or legislation to a diverse audience in a professional setting.  What were your strategies for ensuring understanding and how did you handle communication differences? Please provide an example.

    Application Instructions

    Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.

    Final Filing Date: 8/6/2026

    Who May Apply

    Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list or LEAP eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates apply. Individuals who are eligible for a Training and Development assignment may also be considered for this position(s).

    Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process.     Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).

    How To Apply

    Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at www.CalCareers.ca.gov. When submitting your application in hard copy, a completed copy of the Application Package listing must be included. If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below:

    Address for Mailing Application Packages

    You may submit your application and any applicable or required documents to:

    Covered California
    ECSU
    Attn: Employment & Classification Services - CT
    1601 Exposition Blvd.
    Sacramento, CA 95815

    Address for Drop-Off Application Packages

    You may drop off your application and any applicable or required documents at:

    Covered California
    ECSU
    Employment & Classification Services - CT
    1601 Exposition Blvd.
    Sacramento, CA 95815
    08:00 AM - 05:00 PM

    Required Application Package Documents

    The following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:

    • Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at www.CalCareers.ca.gov. All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
    • Resume is required and must be included.
    • Statement of Qualifications -
      Please attach your SOQ to your application. Applications received without a SOQ may not be considered. Resumes and cover letters will not be accepted in place of a SOQ. Please see above “Special Requirements” section for SOQ instructions.

    Applicants requiring reasonable accommodations for the hiring interview process must request the necessary accommodations if scheduled for a hiring interview. The request should be made at the time of contact to schedule the interview. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this job posting.

    Desirable Qualifications

    In addition to evaluating each candidate's relative ability, as demonstrated by quality and breadth of experience, the following factors will provide the basis for competitively evaluating each candidate:

    Benefits

    The State of California offers a comprehensive benefits package that includes Health, Vision, Dental, Retirement, and an array of other options. For more information on the benefits offered by the State of California, please click below:

     

    CalHR Benefits Summary 

    CalHR Salary and Benefits Information

    CalPERS Retirement Information

    CalPERS Employer Contributions

    Pre-Employment Requirements

    Background Check: All applicants shall be subject to a pre-employment background investigation. The investigation will consist of completion of a pre-employment questionnaire, fingerprinting, and an inquiry to the Department of Justice and Federal Bureau of Investigation to disclose criminal records.

     

    Incompatible Activities: To maintain our integrity and focus on serving Californians, Covered California adheres to unique conflict of interest restrictions on the outside employment and activities of its board members and staff. If you’re considering a role with us, it’s important to know at the time of your start:

     

    • You must not be employed by or otherwise affiliated with health insurance carriers, other insurers, agents, brokers, health care professionals, health facilities, or health clinics, or trade associations of any of these entities. This also means that you must not hold an active license to sell health insurance in California.
    • You must not hold an active license to sell health insurance in California.
    • Health care professionals are welcome to join our team, provided you do not receive payment for professional services and do not hold ownership or financial interests in a health care practice.

    Additional Application Instructions

    Using the online application system as specified in the announcement is the preferred method of applying for civil service job opportunities; however, applicants may instead apply by way of U.S. mail, parcel delivery or courier service, or in person, as set forth in this announcement.

     

    All information regarding your employment history must be included on the State Employment Application STD. 678. Applications that are submitted blank or with “see resume” in place of duties performed or applications received without the following information for each job entry may be considered incomplete and may not be accepted:

    • "To" and "from" dates (month/day/year)
    • Hours worked per week
    • Private sector job titles
    • Supervisor name and phone number
    • Job duties performed
    • State employees must list the specific departments for which they worked and indicate the specific civil service classification titles held (not working titles).

     

    Transcripts:

    If you are meeting minimum qualifications with education, you must include your unofficial transcript for verification. If selected, you will be required to provide official transcripts at the time of hire. Foreign transcripts must include official verification of U.S equivalency prior to appointment by an organization found here.

     

    Personally Identifiable Information:

    Please do not include your Social Security Number, date of birth, veteran status, personal photos, LEAP information, or any other personally identifying information on any documents in your application package.

     

    If you have additional questions regarding this advertisement or are having issues applying through CalCareers, please contact the Employment & Classification Services Unit at 916-228-8386 or careers@covered.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), exercising the right to family care and medical leave, 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.

    It is an objective of the State of California to achieve a drug-free work place. Any applicant for state employment will be expected to behave in accordance with this objective because the use of illegal drugs is inconsistent with the law of the State, the rules governing Civil Service, and the special trust placed in public servants.

    Application Methods:
    Electronic (Using your CalCareer Account)
    By Mail
    Drop-off
    Print Job