California Department of Health Care Services

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.. Under the general direction of the Contract and Enrollment Review Division (CERD), Health Program Audit Manager I, t he Auditor I is the trainee and initial working level of the Health program Auditor (HPA) series.. DHCS is committed to addressing disparities within our organization and in our communities through efforts toward greater diversity, equity, and inclusion.. 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.. 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.

auditor

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 Auditorindividual to join our diverse team in the Auditor I (will also consider HPA II/HPA III/SSMA/AMA) civil service classification. 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: The role of the Auditor is to support the Contract and Enrollment Review Division for DHCS. 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. Under the general direction of the Contract and Enrollment Review Division (CERD), Health Program Audit Manager I, t he Auditor I is the trainee and initial working level of the Health program Auditor (HPA) series. The Auditor I assists in the medical and/or management field audits of Medi-Cal providers and Medi-Cal managed care contracted providers. Travel of up to 20% is required. Overnight travel is routinely required and out of state travel including overnight and/or weekend stays may be required. 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. <ul><li> AUDITOR I </li><li> ASSOCIATE MANAGEMENT AUDITOR </li><li> HEALTH PROGRAM AUDITOR II, DEPARTMENT OF HEALTH SERVICES </li><li> HEALTH PROGRAM AUDITOR III, DEPARTMENT OF HEALTH SERVICES </li><li> STAFF SERVICES MANAGEMENT AUDITOR </li></ul>Additional Documents <ul><li> Job Application Package Checklist </li><li> Duty Statement </li></ul>Position Details Job Code #: JC-431569 Position #(s): 806-102-4175-XXX Working Title: Auditor (Hybrid Option) Classification: AUDITOR I $4,214.00 - $5,279.00 Automatic Hiring Above Minimum for Auditor I is $4,214. Shall Consider: HEALTH PROGRAM AUDITOR II, DEPARTMENT OF HEALTH SERVICES $5,211.00 - $6,851.00 HEALTH PROGRAM AUDITOR III, DEPARTMENT OF HEALTH SERVICES $6,264.00 - $8,238.00 STAFF SERVICES MANAGEMENT AUDITOR $4,214.00 - $6,851.00 ASSOCIATE MANAGEMENT AUDITOR $6,264.00 - $8,238.00 # of Positions: Multiple Work Location: San Francisco County 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 these simple steps: <ul><li> Review the education and experience minimum qualifications (MQ’s) of the Auditor I, Health Program Auditor II/III, Staff Services Management Auditor, and/or Associate Management Auditor classification. See the Minimum Requirements section above. </li><li> Complete an application package and statement of qualifications, if applicable, for this position. </li><li> Submit your application package with all required documents - see Required Application Package Documents section below. . </li><li> Once you have applied, take the Auditor I Examination and/or Staff Services Management Auditor Examination . </li></ul>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: 6/3/2024 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: <ul><li>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. </li><li>Resume is optional. It may be included, but is not required. </li><li>Other - 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. </li></ul>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: <ul><li>Attention to detail</li><li>Problem solving</li><li>Good work ethic</li><li>Strong working knowledge of computer systems</li><li>Strong verbal and written communication skills</li><li>Emotion intelligence</li><li>Ability to conduct contextual analysis</li><li>Independent ability to take initiative </li></ul>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: <ul><li> Continuous and ongoing training </li><li> Diversity, Equity, and Inclusion program activities </li><li> Employee Assistance Program (EAP) </li></ul>Additionally, as a team member of the State of California, you may be eligible for many benefits, such as: <ul><li> Medical, including health, dental, and vision insurance </li><li> Paid Holidays and vacation/leave </li><li> Defined retirement program </li><li> Savings Plus Program (401(k), 457) </li><li> Medical/Dependent Care Reimbursement Accounts </li></ul>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: <ul><li> Training opportunities to support role </li><li> Upward Mobility </li></ul>Contact Information The Hiring Unit Contact is available to answer questions regarding the position or application process. Hiring Unit Contact: Aaron Hernandez (415) 458-6112 Aaron.Hernandez@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: 455 Golden Gate Avenue, San Francisco, CA 94102 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. 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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