health program audit manager iii department of health services - Sacramento County, United States - Department of Health Care Services

Description

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.

Under the general direction of Chief of the Contract and Enrollment Review Division (CERD), CEA B, the Health Program Audit Manager III will serve as the Branch Chief. The incumbent should possess demonstrated management capabilities, including the ability to lead, manage, set priorities, develop objectives, and monitor the performance of a highly technical operation under stressful conditions. The incumbent must be able to direct staff and plan for workloads to meet tight time frames. Upon request by the Division Chief, the incumbent will represent CERD to other Divisions, outside agencies including provider associations, federal agencies, and other local and state agencies. The incumbent must have good communication skills, both written and verbal, to effectively communicate with executive staff, as well as Medi-Cal providers and their attorneys. Statewide travel is required, to include overnight stays, up to 10%.

Have questions and/or need assistance? Contact , 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 .

Working Conditions

Please see the Telework Information section below for telework details.

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 Health Program Audit Manager III 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 (appropriate list for the Health Program Audit Manager III).

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 two pages in length, double-spaced and using 12-point font. You must indicate your Full Name and Job Control Number at the top right corner.

1) Describe your experience overseeing a complex project/program that required significant analytical, managerial and leadership skills. Discuss challenges faced, strategies employed to mitigate risks and ensure successful outcomes, and how your knowledge of departmental goals, governmental functions and legislative processes was leveraged.

2) Describe a time you lead and motivated a team to achieve challenging goals. Discuss how you planned and organized the team's work, communicated objectives, empowered, and developed staff, managed performance to maximize effectiveness and fostered a positive team environment of collaboration and inclusion.

California State Civil Service Employee Benefits Summary Benefit Description​ ​Additional Information ​ New Employee Benefits Orientation Page
Summary review of benefits available to you as a new State Civil Service employee. ​ State Civil Service Act

Review the benefits and protections provided to State Civil Service employees through the State Civil Service Act.

​ Salaries and Civil Service Pay Scales

Information regarding salary ranges for State Civil Service employees, as well as the Civil Service Pay Scales, the official salaries for all state jobs.

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​ Represented Employee Bargaining Contracts

Review the specifics of represented state employee collective bargaining contracts.

​ Retirement

Learn more about the defined benefit plan that is offered to state employees through the California Public Employees' Retirement System (CalPERS) based on years of service, age and final compensation. CalPERS also offers disability retirement, partial service retirement, and death benefits for eligible employees.

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401(k) and 457(b) Plans (Savings Plus)

Offers a voluntary benefit that allows you to contribute to both a 401(k) and a 457(b) plan to enhance your retirement benefit. This allows you to contribute, through payroll deduction, up to twice the amount available to the private sector and most public sector employees. You can contribute on both a pre-tax and an after-tax designated Roth basis that offers you the opportunity to take advantage of tax savings now and in the future.

​ California State Civil Service Employee Benefits Summary - Specific Benefits ​Specific Benefits ​Additional Information

Cash In Lieu of Health and/or Dental Benefits (Cash Option)

Allows you to receive cash in lieu of state-sponsored health and/or dental benefits insurance if you have other qualifying medical and/or dental coverage through a spouse, domestic partner, parent or other source.

​ ​ Common Carrier Travel and Accident Insurance – for Excluded Employees Only

Offers employer-paid accidental death and dismemberment insurance to managers, supervisors and other specified employees who travel on state business.

​ ​ Commute Program

Voluntary benefits that subsidize commuting expenses for eligible employees who commute to and from work using public transportation, vanpools, or bicycles.

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​ Consolidated Benefits (CoBen)

Provides a benefit allowance, rather than specific contribution amounts for health, dental and vision benefits. You may receive additional taxable income each month, depending on the total cost of the benefit plans you choose.

​ ​Consolidated Omnibus Budget Reconciliation Act (COBRA)

Continuation of health, dental, and vision insurance coverage as well as medical reimbursement account for employees and eligible dependents who involuntarily lose coverage.

​ Death Benefits

Benefits available to legal survivors and/or designees of state employees; see "Planning Ahead" handbook.

​Planning Ahead Handbook | ​Dental Benefits

Offers you and your dependents preventive, basic and major dental care coverage through one of several dental plans.

​ Employee Assistance Program

Employer-paid program offers free professional and confidential short-term counseling and referral services to employees and their eligible dependents, as well as valuable information on a variety of topics including financial, legal, and wellness.

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(866) EAP-4SOC

TDD

California State Civil Service Employee Benefits Summary Benefit Description​ ​Additional Information

Group Legal Services Insurance
Voluntary, employee-paid plan that provides comprehensive legal coverage designed to meet most common personal legal needs. Available to eligible employees and their eligible dependents.

TDD

​Group Long-Term Disability Insurance – For Excluded Employees Only

Voluntary, employee-paid plan that replaces a portion of the employee's income in the event the employee is unable to work for six months or longer due to a covered illness or injury.

Health Benefits

Offers you and your dependents a broad range of health insurance plans with the state paying a portion of the premium. CalPERS administers this coverage.

CalPERS Health and Wellness

Promotes a work environment that encourages healthy lifestyle choices, decreases the risk of illness and disease and enhances employee effectiveness and well-being.

​ Long-Term Care Program

Offers coverage through CalPERS for a chronic illness, frailty of old age, or a serious accident. Available to all California public employees, retirees, and their eligible family members.

​ ​Part-time, Seasonal, and Temporary Retirement Program

Offers a retirement savings program for part-time, seasonal and temporary employees who are not covered by CalPERS or Social Security.

​ ​ Reimbursement Accounts

Allows you to set pre-taxed money aside in a reimbursement account to pay for certain kinds of medical and dependent care expenses. You can increase your take home pay and decrease your taxable income.

​ ​ Third-Party Pre-Tax Parking Reimbursement Account Program

Allows you to deduct a specific pre-tax amount for work-related parking fees from your pay. Available to employees who drive a personal vehicle to work or to a location from which the employee commutes to work and pays for parking.

​ ​Vision Benefits

Employer-paid benefit that offers you and your dependents an annual eye examination and an allowance for frames and lenses. An enhanced vision plan is also available which provides higher allowances for certain materials and other benefits.

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