HEALTH PROGRAM AUDIT MANAGER I, DEPARTMENT OF HEALTH SERVICES

State of California•Sacramento, CA

33d•Hybrid

About The Position

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 Audit Manager plans, organizes and directs the financial and medical audits performed by the audit staff. Assigns the audits, approves pre-onsite audit plans, oversees onsite reviews, oversees post onsite audit activity, reviews work papers, develops and improves audit programs, and reviews audit reports. Manages the operations of a unit of staff which includes direct supervision, recruitment, hiring, training, and evaluation of subordinate staff which includes, but is not limited to, completion of timely performance appraisals; and, establishing personnel policies. Travel may be required, to include overnight stays, up to 10%. The Staff Management Auditor eligible list may be used to fill this position. Candidates whose eligibility is based on results from the Staff Management Auditor exam must meet the minimum qualifications of both the Health Program Audit Manager I and Staff Management Auditor classifications. Have questions and/or need assistance? Contact [email protected], 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.

Requirements

You will find the Minimum Requirements in the Class Specification.
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.
Please describe your experience and education as it relates to the job duties.
Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered.
Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).

Nice To Haves

Enthusiastic and self-motivated
Good communication skills (both written and verbal)
Strong work ethic and ability to persevere

Responsibilities

Plans, organizes and directs the financial and medical audits performed by the audit staff.
Assigns the audits, approves pre-onsite audit plans, oversees onsite reviews, oversees post onsite audit activity, reviews work papers, develops and improves audit programs, and reviews audit reports.
Manages the operations of a unit of staff which includes direct supervision, recruitment, hiring, training, and evaluation of subordinate staff which includes, but is not limited to, completion of timely performance appraisals; and, establishing personnel policies.
Travel may be required, to include overnight stays, up to 10%.