RESEARCH DATA SPECIALIST II

State of California•Sacramento, CA

53d•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! The Capitated Rates Development Division is responsible for the development of managed care capitation rates for more than 10 million Medi-Cal beneficiaries in all of California's 58 counties. Under the general direction of the Section Chief, the Research Data Specialist II (RDS II) designs and directs major, complex research projects or activities. The incumbent independently plans, organizes, and conducts complicated studies, requiring in-depth knowledge, pertaining to the Medi-Cal managed care financial delivery system, such as intergovernmental transfer programs, directed payments, Medi-Cal managed care plan (MCP) financial reporting, medical loss ratio reporting, managed care waiver programs and reporting, budgetary analysis and policy changes for the Local Assistance Estimate, and the enforcement of Centers for Medicare and Medicaid Services (CMS) special terms and conditions. The RDS II provides expert consultative services on the feasibility, impact, or potential of proposed initiatives, policy changes, or program changes. The purpose of the studies is to advise the Division's management of the performance of Medi-Cal managed care health plans and to positively influence future policies and strategies to meet statewide health policy goals. Other duties include performing complex analysis to support and assist actuaries setting managed care rates, as well as developing program calculations. Managing encounter, eligibility, demographic, and other data required for the Medi-Cal Managed Care program. The incumbent also assists with duties including but not limited to: capitation payment support, financial audits, risk corridors, and incentive programs. You will find additional information about the job in the Duty Statement.

Requirements

Review the education and experience minimum qualifications (MQ's) of the Research Data Specialist II CalHR.
Complete the statement of qualifications and the state application by clicking "Apply Now" above.
Submit your application package with all required documents, which include the statement of qualifications
Once you have applied, take the Research Data Specialist II Examination
Applicants must include a Statement of Qualifications (SOQ) for this recruitment.
The SOQ must be in 12-point Arial font, single-spaced, and no more than 2 pages in length.
Describe your education, training, and experience related to conducting empirical research and evaluation. Please include a description of your experience with specific research methods and experience conducting research in an applied setting.
Describe your work experience leading projects and speaking to internal and external stakeholders.
Candidates who do not complete and submit a SOQ may not be considered for this position.
Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered.
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 required and must be included.
Statement of Qualifications

Responsibilities

Designs and directs major, complex research projects or activities.
Independently plans, organizes, and conducts complicated studies, requiring in-depth knowledge, pertaining to the Medi-Cal managed care financial delivery system, such as intergovernmental transfer programs, directed payments, Medi-Cal managed care plan (MCP) financial reporting, medical loss ratio reporting, managed care waiver programs and reporting, budgetary analysis and policy changes for the Local Assistance Estimate, and the enforcement of Centers for Medicare and Medicaid Services (CMS) special terms and conditions.
Provides expert consultative services on the feasibility, impact, or potential of proposed initiatives, policy changes, or program changes.
Advises the Division's management of the performance of Medi-Cal managed care health plans and to positively influence future policies and strategies to meet statewide health policy goals.
Performs complex analysis to support and assist actuaries setting managed care rates, as well as developing program calculations.
Managing encounter, eligibility, demographic, and other data required for the Medi-Cal Managed Care program.
Assists with duties including but not limited to: capitation payment support, financial audits, risk corridors, and incentive programs.