Nurse Specialist Program Evaluation

University of California San Francisco•Sacramento, CA

About The Position

This position is based in Sacramento. Travel is required; 2 to 3 days a month to sites in California. The Medi-Cal Waiver Program (MCWP) will be sunsetting at CDPH as early as 2028, meaning the UCSF Nurse Specialist - Program Evaluation position will end at the same time. California is transitioning to an integrated managed long-term services and supports (MLTSS) system to improve the efficiency of program administration, operations, and service delivery systems allowing Californians to more effectively find and obtain high-quality person-centered care and enhancing the state’s ability to predict Medi-Cal costs and measure member outcomes. The Department of Health Care Services (DHCS) released a gap analysis report in February 2025 and is now using its findings to collaborate with sister state departments and key stakeholders to develop a multi-year roadmap to integrate select Home and Community Based Services (HCBS) services into managed care. DHCS plans to draft and submit a concept paper for HCBS managed care integration to the Centers of Medicare & Medicaid Services (CMS) in early 2026 before finalizing the multi-year roadmap, with integration occurring no earlier than 2028. The California Department of Public Health (CDPH), Office of AIDS (OA), Nurse provides highly specialized consultation, technical assistance (TA), training and education to CDPH/OA staff and Medi-Cal Waiver Program (MCWP) Agency personnel. Uses practical nursing knowledge, professional expertise, and sound clinical judgment to serve as the MCWP Nurse performing all MCWP clinical functions to ensure that MCWP participants receive high quality and appropriate care, that MCWP Agencies meet state and federal clinical compliance requirements, and that CDPH/OA meets Centers for Medicare and Medicaid Services (CMS) Home and Community Based Services (HCBS) 1915(C) MCWP Waiver requirements. Evaluates and certifies Nursing Facility Level of Care (NF LOC) for MCWP participants, conducts the clinical portion of Program Compliance Reviews (PCRs) through on-site monitoring and desk audits for MCWP Agencies, and documents progress on meeting CMS HCBS performance measures. Creates and facilitates clinical internal and external trainings, and writes the clinical sections of MCWP plans, reports, surveys, drills, and requests for information. Analyzes medical data and documentation, identifies trends and barriers, develops and presents recommendations to CDPH/OA management. The final salary and offer components are subject to additional approvals based on UC policy. Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. The salary range for this position is $140,800 - 150,000 (Annual Rate). To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html

Requirements

Bachelor of Science in Nursing (BSN) and two years of experience as an RN.
Five years related experience or equivalent experience/training
In depth knowledge of medical case management principles and standards of care
In depth knowledge of HIV and AIDS disease process and clinical standards of care for People Living with HIV
Ability to analyze clinical data and assess level of care needs, medical case management as well as other support services
In depth knowledge of Quality Improvement standards, clinical chart review, abstraction, and regulatory requirements
Detail oriented, with proven ability to effectively manage time, see projects through to completion, organize competing priorities and effectively address complex, urgent issues as they arise
Strong critical thinking and problem-solving skills to manage multiple levels of information and responsibilities, assess complex problems, develop and implement timely and effective solutions.
Advanced organizational and project management skills, with the ability to lead a team, prioritize tasks, and see projects through from inception to completion on schedule
Strong interpersonal skills for collaborating effectively with a broad range of clinical and technical staff.
Advanced skills to influence and persuade staff, management, and clinicians at all levels and across departments
Ability to apply increasing independence in clinical judgment, management concepts and provide counseling.
Advanced critical thinking and problem-solving skills to manage multiple levels of highly complex information and responsibilities, to quickly assess problems, and to develop and implement timely and effective solutions
Ability to work in a multi-disciplinary, collaborative work environment.
Advanced interpersonal skills for collaborating effectively with all levels of clinical and technical staff and representatives of external regulatory agencies
Able to follow written and verbal directions accurately
Advanced skills required to effectively convey complex clinical and technical information both verbally and in writing, prepare and complete quality reports and documentation
Advanced knowledge of various administrative and business software packages, and of specialized applications for quality data management.
Strong knowledge of various administrative and business software packages including Word, Excel, PowerPoint, etc., ability to utilize specialized applications for quality data management
Must possess valid and current licensure as a Registered Nurse in the State of California
Possession of the legal requirements to practice as a Registered Nurse as determined by the California Board of Registered Nursing and knowledge and abilities essential to the successful performance of the duties assigned to the position