Quality Assurance Tier I Evaluator

Job Description and Duties

Are you a skilled leader with a passion for quality assurance and customer service? Under general direction of the Quality Assurance (QA) Supervising Program Technician III (SPT III), the Program Technician III (PT III), Quality Assurance Technician, reviews, evaluates, and monitors a broad representative sample of consumer transactions which may include: calls, chat interactions, enrollment applications, manual verifications, and the life cycle of consumer interactions, etc., for quality assurance and control purposes. In an area of great expectations for Covered California, quality customer service is of paramount importance. PT III’s are dedicated to reviewing, monitoring, and recording the customer service provided to consumers for accuracy of information and adherence

to departmental, Federal, and State regulations, policies, and procedures. Duties may include access to information systems containing protected enrollee information, including federal tax information, protected health information, and personally identifying information.

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 .

This position’s office headquarters location is designated at 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 to access the Program Technician III 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 .

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.

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.

Statement of Qualifications: This should be a narrative discussion of how your education, experience, skills, and training have prepared you for the position. It also serves as documentation of your ability to present information clearly and concisely in writing. The SOQ should be no more than two pages in length, single spaced, in Arial 12-point font, and should include your full name and position number on each pages’ header.

• Describe your experience reviewing customer interactions, work products, or transactions against established policies.  How did you ensure your reviews were accurate, consistent, and documented, while adapting to changes in criteria and protecting confidential information?
• Describe a time you identified an error, trend, or process gap through your work.  How did you assess its impact, communicate your findings, and help address it?  What was the outcome?

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:

1. Experience interpreting and implementing policies and procedures.
2. Experience working as part of a team and collaborating with others to meet objectives.
3. Experience delivering professional verbal and written communication.
4. Experience in a call center or high-production environment
5. Experience working with Quality Assurance programs or guidelines is preferred but not required.

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:

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.

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 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 an SOQ will not be considered. Please see below for SOQ instructions.