Chief Clinical Assurance Division Leader

1 day ago


Davis, California, United States Department of Health Care Services Full time
About this Role:

The Department of Health Care Services (DHCS) is seeking a highly skilled and experienced professional to serve as the Chief, Clinical Assurance Division (CAD). This is a critical leadership position that requires a strong understanding of health care policy, utilization management, and program administration.

Key Responsibilities:
  • Lead the CAD team in the implementation of utilization management for Medi-Cal fee-for-service members in partnership with the DHCS Health Care Benefits and Eligibility (HCBE) program.
  • Develop and implement policies and procedures to ensure effective utilization management and program integrity.
  • Collaborate with stakeholders, including federal and state agencies, counties, and health care providers, to ensure alignment and coordination of efforts.
  • Oversee the administration of Treatment Authorization Requests (TARs), the TAR-free program, and post-payment utilization control of Medi-Cal benefits.
Requirements:
  • Master's degree in a relevant field, such as health administration, public health, or a related field.
  • Minimum 5 years of experience in health care policy, utilization management, or program administration.
  • Strong leadership and management skills, with experience in leading cross-functional teams.
  • Excellent communication and interpersonal skills, with the ability to build and maintain relationships with stakeholders.


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