Job Description and Duties

Why Join DHCS?

The Department of Health Care Services (DHCS) is a dynamic organization with ambitious goals and talented, committed team members. We work hard every day to fulfill our vital responsibility to support the delivery of quality health care to millions of Californians.

This is an exciting opportunity to work in the Contract and Enrollment Reivew Division, Audits and Investigations. Our mission is to protect and enhance the integrity of the health programs administered by DHCS. We are seeking an individual to join our diverse team in the Nurse Evaluator II civil service classification. If you are interested in joining our team, apply today!

This position is a statewide recruitment, the incumbent will be headquartered in the county nearest their residence, including but not limited to the following counties: Sacramento and Los Angeles.

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

About this Role:

The role of the Nurse Evaluator II is to:

To assure the proper and efficient operation of the Medi-Cal Program, the Nurse Evaluator II (NE II) uses professional nursing knowledge, expertise and judgment to perform program integrity functions which include onsite reviews of Medi-Cal providers, evaluation of medical documentation of services and drugs, and provision of expert medical testimony at administrative appeal and criminal hearings in collaboration with management and legal counsel. The incumbent must have the ability to act independently, be flexible, open minded, and tactful in dealing with team members, audit leads and managers, and executive management. The incumbent must be able to accurately convey medical program integrity findings effectively both orally and in written form.

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.

Minimum Requirements

You will find the Minimum Requirements in the Class Specification.

• NURSE EVALUATOR II, HEALTH SERVICES

Additional Documents

• Job Application Package Checklist

• Duty Statement

Position Details

Job Code #:

JC-429319

Position #(s):

806-410-8144-701

Working Title:

Nurse Evaluator II (Hybrid)

Classification:

NURSE EVALUATOR II, HEALTH SERVICES

$7,004.00 - $9,197.00

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.

Investigations Division (ID) conducts administrative and criminal investigations to address fraud, waste and abuse in Medi-Cal and other DHCS programs. Specific activities include fraud data analytics, Medi-Cal fraud Hotline and complaint intake, investigative audits, provider fraud investigations, and beneficiary fraud investigations.

ID Research is seeking a candidate to join as a Nurse Evaluator II. Please direct all questions to the hiring contact listed in this job posting.

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 these simple steps:

• Review the education and experience minimum qualifications (MQ's) of the Nurse Evaluator II 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. .

• Once you have applied, take the Nurse Evaluator II Examination.

At all times it is required that the incumbent maintain a valid and active registered nursing license with the California Board of Registered Nursing.

Education: If you are meeting minimum qualifications with education, you must include a copy of your diploma/degree and/or unofficial/informal transcripts for verification. Official transcripts may be required upon appointment.

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

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: 5/14/2024

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 - The Statement of Qualifications (SOQ) should be no more than 2 pages in length (one and a half space, 1 inch left and right margins, and a font size comparable to Arial 12 point).

Please describe your experience and education as it relates to job duties.

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 maintain consistent and regular attendance; communicate effectively, orally and in writing, in dealingwith the public and/or other employees; develop and maintain knowledge and skill related to specific tasks, methodologies, materials, toolsand equipment; complete assignments in a timely and efficient manner; and, adhere to departmental policies and procedures regardingattendance, leave, and conduct.

Self-motivated and a good communicator both verbal and written. Position requires the NE II to conduct field work audit and interact withthe public in a variety of settings. Clinical experience in acute care settings.

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:

Labebe Bustamante

(916) 713-8956

Labebe.Bustamante@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

This position may be eligible for telework up to three days per week and is required to report in-person and site-based a minimum of two days per week. The amount of telework is at the discretion of the Department and is subject to change consistent with DHCS' Telework Program and Government Code sections 14200 - 14203. Telework is available to California residents, and proof of residency may be required.

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.

The DHCS office location for this position is: 7575 Metropolitan Drive, Suite 102, San Diego, CA 92108

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.

A completed state application (STD. 678) and any documents list under "Required Application Documents" must be submitted with your application package. Applicants who are relying on additional documentation (e.g., transcripts, copy of degrees, certifications, licenses, etc.) in order to prove that they meet the minimum qualifications listed in the Classification Specification (located on the right under "Additional Documentation) must submit those documents with their application package.

Failure to submit these documents may result in your application being disqualified. Applications must include a description of the duties performed for each position held; reference to a resume in place of a description of the duties performed will not be accepted.

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.

Here is the link to the exam information for the Nurse Evaluator II Examination. 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.