{"id":1344549,"url":"https://alion.io/job/blueshieldca-regulatory-complaint-coordinator-intermediate","title":"Regulatory Complaint Coordinator, Intermediate","company":{"id":1766006,"name":"BlueShieldCA","domain":"blueshieldca.com","url":"https://alion.io/company/blueshieldca","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Oracle","truth_index":{"grade":"B","score":75,"open_postings":3,"ghost_share":0,"stale_share":1,"repost_share":0,"time_to_fill_p50_days":31,"computed_at":"2026-10-03T05:45:00Z"}},"role":"Administrative","role_family":"Administrative","seniority":"middle","employment_type":null,"work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["El Dorado Hills, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":48000,"max_usd":94000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":856},"experience_years_min":3,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"closed","first_seen_at":"2026-09-14T17:48:46Z","employer_posted_date":"2026-09-14","last_verified_at":"2026-10-03T09:11:46Z","board_verified":false,"closed_at":"2026-10-03T09:11:46Z","days_open":18,"trust":{"level":"not_scored","repost_count":null,"flags":[],"days_open":18},"description":"Your Role\nThe Appeals and Grievance Department Regulatory team is responsible for responding to inquiries received directly from our state regulatory agencies. The Regulatory Complaint Coordinator, Intermediate, will report to the Regulatory Complaint Supervisor. In this role you will be responsible for effectively managing your time daily to ensure you are meeting and/or exceeding compliance, quality, and production metrics.\nOur leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.\n Your Work\nIn this role, you will:\nPrepare detailed file summary responses for submission to multiple regulatory, legislative, and accreditation agencies.\nBe involved in evaluating and researching end-to-end timelines of member health provider services, claim processing, and other data to determine decision and/or alternative ways to resolve grievance/appeal.\nRespond to the most complex and highest financial and/or goodwill impact regulatory complaint inquiries.\nResearch the data files and develop a timeline of events and gather missing information from third parties such as medical providers, to determine the response to the inquiry.\nRespond to correspondence addressed to highest level executives regarding issues and/or concerns that an individual (member or non-member) may have.\n Your Knowledge and Experience\nRequires a high school diploma or GED\nRequires at least 3 years of experience\nRequires at least 2 years in health insurance operations such as I&M, Claims, Customer Services, Regulatory Affairs and/or Appeals/Grievances, at least 1 year of which is Appeals/grievance direct experience, or similar combination\nHybrid Virtual Work\nThis role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.","description_format":"text","description_chars":2078,"description_truncated":false,"requirements":{"experience_years_min":3,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":false},"security_clearance":false,"languages":[]},"benefits":["Continuous learning","Health insurance"],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":["Health Care","Health Insurance & Benefits"],"lifecycle":[{"event":"open","at":"2026-09-27T16:21:10Z"},{"event":"close","at":"2026-10-03T09:11:46Z"}],"visa":[],"liveness":null,"pay":null,"html_url":"https://alion.io/job/blueshieldca-regulatory-complaint-coordinator-intermediate","json_url":"https://alion.io/job/blueshieldca-regulatory-complaint-coordinator-intermediate.json","meta":{"generated_at":"2026-10-04T02:04:46Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","usage":{"tier":"crawler","counted_by":"address","units_charged":1,"used_today":2870,"day_limit":5000,"remaining_today":2130,"minute_limit":60,"resets_at":"2026-10-05T00:00:00Z"}}}