STAFF SERVICES MANAGER I

State of California•Sacramento, CA

44d•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 (CRDD) is responsible for developing and processing Medi-Cal managed care capitation rates for more than 10 million beneficiaries across California's 58 counties. Under the general direction of the Section Chief, the Staff Services Manager I (SSM I) manages the daily and long-term activities of a Financial Management Unit (FMU). The FMU has primary responsibility for non-actuarial, capitated rate-related functions with regard to Medi-Cal managed care plans (MCPs). These functions include, but are not limited to, the development, analysis, and implementation of Medi-Cal managed care capitation rates; oversight of MCPs' financial viability and compliance with statutory, regulatory, and contractual requirements regarding financial matters; development of complex fiscal analyses and policy changes required for Medi-Cal budget assumptions (Local Assistance Estimate); development of payment policy, regulation, and monitoring and evaluation of Medi-Cal managed care delivery system waiver initiatives, including Special Terms and Conditions; development and/or review of State Directed Payments, Medical Loss Ratio (MLR) or other risk mitigation calculations; and implementation of and ongoing compliance with federal Centers for Medicare and Medicaid Services (CMS) regulations and guidance related to managed care rate setting. The SSM I is required to coordinate with multiple internal and external entities to meet all requirements for various CRDD programs. These entities include, but are not limited to, CMS, MCPs, counties, hospitals, health care districts, medical centers, MCP and provider associations, and accounting, budget, fiscal forecasting, and other internal Department of Health Care Services divisions.

Requirements

You will find the Minimum Requirements in the Class Specification.
Applicants must include a Statement of Qualifications (SOQ) for this recruitment.
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 - see the "Required Application Package Documents" section below.
Once you have applied, take the Staff Services Manager I Staff Services Manager 1 Examination.
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).
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

Nice To Haves

Finance, economics, accounting, or budgets background preferred.
Experience in Medicaid or Medi-Cal preferred.
Prior management experience preferred.
Experience with project management concepts to track multiple projects or assignments.
Program implementation experience.
Experience working with large amounts of data.
Advanced Microsoft Excel formula skills.
Excellent written communication with various stakeholders.
Experience researching policy, statute, or legislation.
Excellent attention to detail.
Initiative driven and accountable individual.
Ability to oversee a high-functioning team

Responsibilities

Manages the daily and long-term activities of a Financial Management Unit (FMU).
Primary responsibility for non-actuarial, capitated rate-related functions with regard to Medi-Cal managed care plans (MCPs).
Development, analysis, and implementation of Medi-Cal managed care capitation rates
Oversight of MCPs' financial viability and compliance with statutory, regulatory, and contractual requirements regarding financial matters
Development of complex fiscal analyses and policy changes required for Medi-Cal budget assumptions (Local Assistance Estimate)
Development of payment policy, regulation, and monitoring and evaluation of Medi-Cal managed care delivery system waiver initiatives, including Special Terms and Conditions
Development and/or review of State Directed Payments, Medical Loss Ratio (MLR) or other risk mitigation calculations
Implementation of and ongoing compliance with federal Centers for Medicare and Medicaid Services (CMS) regulations and guidance related to managed care rate setting
Coordinate with multiple internal and external entities to meet all requirements for various CRDD programs.