health program audit manager iii department of health services
1 week ago
Job Posting: Branch Chief (Hybrid Option)
Department of Health Care Services
JC Branch Chief (Hybrid Option)HEALTH PROGRAM AUDIT MANAGER III DEPARTMENT OF HEALTH SERVICES
$9, $11,371.00 per Month
Final Filing Date: 6/10/2024
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%.
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