Health Program Auditor IV, Department Of Health Services

State Of California Sacramento , CA 94204

Posted 1 week ago

Job Description and Duties

Why Join DHCS?

The Department of Health Care Services (DHCS) is the backbone of California's health care safety net. Our success is made possible by the hard work of more than 4,800 DHCS team members and through collaboration with the federal government and other state agencies, counties, and partners for the care of low-income families, children, pregnant women, older adults, and persons with disabilities.

This is an exciting opportunity to join our diverse team in the following role. If you are interested in joining our team, apply today!

Please see the Special Requirements section for simple and easy steps on how to apply for this state position.

About this Role:

CERD conducts state mandated medical and compliance reviews and audits to verify compliance with contractual requirements. Provider types audited include medical, dental and behavioral health managed care plans; Drug Medi-Cal Organized Delivery Systems. Other work performed include federally mandated post-service, post-payment behavioral health utilization reviews; provider enrollment onsite reviews of high and moderate risk prospective Medi-Cal providers; onsite reviews for site certification and recertification of county-owned or operated Specialty Mental Health providers; and other requested third-party contract compliance reviews.

Our focus is to improve the effectiveness and efficiency of DHCS and the programs it administers.

The Health Program Auditor (HPA) IV is the most advanced auditor level and is considered the Section specialist. The HPA IV is a promotional position and requires knowledge of Medi-Cal reimbursement and candidates must possess this valuable knowledge. Travel of up to 15% is routinely required and may include overnight, and/or weekend stays.

Have questions and/or need assistance? Contact Recruit@dhcs.ca.gov, we are here to help walk you through the state hiring process!

This position is subject to the Department's Conflict of Interest Code and requires annual filing of a Statement of Economic Interests (Form 700).

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

Working Conditions

Please see the Telework Information section below for telework details.

This is a statewide recruitment, and the position may be located in the following locations: Sacramento, San Francisco, Orange (Santa Ana), San Bernardino (Rancho Cucamonga), San Diego and Los Angeles.

Minimum Requirements

You will find the Minimum Requirements in the Class Specification.

  • HEALTH PROGRAM AUDITOR IV, DEPARTMENT OF HEALTH SERVICES

Additional Documents

  • Job Application Package Checklist

  • Duty Statement

Position Details

Job Code #:

JC-436556

Position #(s):

806-107-4249-XXX

Working Title:

Health Program Auditor IV (Hybrid Option)

Classification:

HEALTH PROGRAM AUDITOR IV, DEPARTMENT OF HEALTH SERVICES

$6,555.00 - $8,617.00


of Positions:


Multiple

Work Location:

United States

Telework:

Hybrid

Job Type:

Permanent, Full Time

Department Information

DHCS is California's health care safety net, helping millions of low-income and disabled Californians each and every day. DHCS' purpose is to provide equitable access to quality health care leading to a healthy California for all.

DHCS is a dynamic organization with ambitious goals and talented, committed employees. We work hard every day to fulfill our vital responsibility to support the delivery of quality health care to Californians.

DHCS is committed to addressing disparities within our organization and in our communities through efforts toward greater diversity, equity, and inclusion. This is accomplished, in part, by a commitment toward employing a diverse workforce that reflects the many communities we serve, and by promoting and enforcing equal employment opportunity.

Take a look at some of DHCS' recent projects and happenings that our department has accomplished in the DHCS Newsroom

Special Requirements

Simple Application Steps

If you are interested in this position, complete the following simple steps:

  • Review the education and experience minimum qualifications (MQ's) of the Health Program Auditor IV classification. See the Minimum Requirements section above.

  • Complete an application package and statement of qualifications, if applicable, for this position.

  • Submit your application package with all required documents - see Required Application Package Documents section below.

All current Health Program Auditor III that have taken the Health Program Auditor IV exam are encouraged to apply.

DHCS will review your application package and contact you after the job posting/final filing date.

Statement of Qualifications Requirement Section

Candidates who do not complete and submit an SOQ may not be considered for this position.

Applicants must include a Statement of Qualifications (SOQ) for this recruitment. The SOQ is a narrative discussion, not a cover letter, prepared by the applicant describing how their skills, knowledge, abilities, education, training, and experience, qualify them for the position.

The SOQ serves as documentation of the applicant's ability to present information clearly and provide DHCS additional information about their experience and qualifications concisely in writing. The DHCS may not consider applicants who fail to provide an SOQ with their application. Resumes do not take the place of the SOQ.

The SOQ must be no more than 1-page in length, single-spaced and using 12-point font. You must indicate your Full Name and Job Control Number at the top right corner.

Based on the Duty Statement for this position, please describe how your relevant work experience and/or education qualify you for this position.

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: 7/3/2024

Who May Apply

Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list 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:

Department of Health Care Services

Attn: Certification Technician

M.S. 1300

P.O. Box 997411

Sacramento, CA 95899-7411

Address for Drop-Off Application Packages

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

Department of Health Care Services

1501 Capitol Avenue, Suite 71.1501

Sacramento, CA 95814

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 optional. It may be included, but is not required.

  • Statement of Qualifications - A completed Statement of Qualifications (SOQ) must be submitted with your STD. 678 in order to be considered for this position.

    The statement of qualifications helps DHCS better understand your qualifications and experience as it relates to the role in which you are applying. Please see the Statement of Qualifications Requirement Section above for additional information.

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:

This position requires the incumbent to have and maintain good rapport, consistent and regular attendance, communicate effectively both orally and in writing in dealing with the public and/or other employees. Please indicate your eligibility in the area of the application where you enter the position name and number for which you are applying.

Desirable skills include:

  • Enthusiastic and self-motivated

  • Good communication skills (both written and verbal)

  • Strong work ethic and ability to persevere

Benefits

The DHCS is dedicated to creating an innovative workplace for its team members that is inclusive, diverse, and interactive! Here are a few of the ways we stay engaged with our team:

  • Continuous and ongoing training

  • Diversity, Equity, and Inclusion program activities

  • Employee Assistance Program (EAP)

Additionally, as a team member of the State of California, you may be eligible for many benefits, such as:

  • Medical, including health, dental, and vision insurance

  • Paid Holidays and vacation/leave

  • Defined retirement program

  • Savings Plus Program (401(k), 457)

  • Medical/Dependent Care Reimbursement Accounts

Full benefits information can be found on CalHR's California State Civil Service Employee Benefits Summary

DHCS 2023-2025 Strategic Plan provides more information about our commitment to organizational excellence to ensure we meet the needs of our workforce and members.

In addition, DHCS - Audits & Investigations offer:

  • Training opportunities to support role

  • Upward Mobility

Contact Information

The Hiring Unit Contact is available to answer questions regarding the position or application process.

Hiring Unit Contact:

Scott Hamamura

(909) 727-5755

Scott.Hamamura@dhcs.ca.gov

Please direct requests for Reasonable Accommodations to the interview scheduler at the time the interview is being scheduled. You may direct any additional questions regarding Reasonable Accommodations or Equal Employment Opportunity for this position(s) to the Department's EEO Office.

EEO Contact:

EEO Officer

(916) 440-7370

civilrights@dhcs.ca.gov

California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device.

DHCS Telework Information

The DHCS standard for hybrid work is a minimum of two days per week in-person and site-based and up to three teleworking days per week in accordance with DHCS' Telework Program and Government Code sections 14200 - 14203. This position may be eligible for telework up to five days a week, contingent on operational business needs. The amount of telework is at the discretion of the Department and is subject to change.

The selected candidate will be assigned an available DHCS office closest to their residence prior to their start date. The selected candidate will be required to report to their assigned DHCS office and other DHCS locations as needed.

Business travel may be required, and reimbursement considers an employee's designated office and residence subject to regulations and bargaining unit contract provisions. All commute expenses to the reporting location will be the responsibility of the selected candidate.

For a list of possible DHCS office assignment locations, please reference the reporting location document attached to the duty statement on this job advertisement.

Additional Information

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.

Paper applications must include a signature. Dates printed on envelopes by mobile barcodes or equivalent mobile print technology are not acceptable proof of the date the application and any other required documents or materials were filed.

Applicants must state their basis of eligibility (List Eligibility, Lateral Transfer, Reinstatement, T&D, or Surplus/SROA), and the Job Control (JC) number and/or position number in the "Examination(s) or Job Title(s), For Which You Are Applying" section on the STD. 678. Surplus/SROA candidates should submit a copy of their letter with their application. Please remove any confidential information (i.e., social security number, date of birth, etc.) as well as any information regarding your LEAP eligibility and/or exam scores from your documents prior to submission.

If applying electronically, please note that CalCareers no longer allows applicants to withdraw their applications. If you need assistance to withdraw your application, please contact the Recruitment Section at Recruit@dhcs.ca.gov For all other questions regarding your CalCareer account, please contact CalHR's CalCareers Unit at (866) 844-8671 or CalCareer@calhr.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.


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Health Program Auditor IV, Department Of Health Services

State Of California