Healthcare Compliance Specialist I

2 weeks ago


Sacramento, California, United States Department of Health Care Services Full time

Position Overview

Join the Department of Health Care Services (DHCS), a pivotal entity in California's healthcare system, dedicated to supporting low-income families, children, pregnant women, seniors, and individuals with disabilities. This role presents a unique opportunity to contribute to our mission and work within a diverse team.

Role Responsibilities:

The Health Program Specialist I (HPS I) will operate under the guidance of the Unit Chief, acting as a proficient technical consultant. The HPS I will engage in a variety of essential tasks, including:

  • Conducting mandated medical and compliance evaluations to ensure adherence to contractual obligations.
  • Performing audits of various provider types, including managed care plans and substance use disorder providers.
  • Facilitating federally required post-service behavioral health utilization reviews.
  • Assisting in provider enrollment assessments for high-risk Medi-Cal providers.
  • Supporting site certification and recertification processes for county-operated Specialty Mental Health providers.

This position requires occasional travel (up to 15%) and may involve overnight stays.

Key Focus:

Our aim is to enhance the operational effectiveness of DHCS and the programs we oversee. The HPS I will collaborate with multi-division teams, providing consultative support on legislation, policy development, internal quality controls, and business process enhancements.

Application Process:

For candidates interested in this role, please follow the outlined application steps:

  1. Review the minimum qualifications for the Health Program Specialist I classification.
  2. Prepare and submit an application package along with a Statement of Qualifications, if applicable.
  3. Ensure all required documents are included in your application submission.

Statement of Qualifications:

Applicants must provide a Statement of Qualifications (SOQ) detailing their relevant skills, knowledge, and experience. This narrative should not exceed two pages, double-spaced, and formatted in 12-point Arial font. The SOQ is crucial for consideration.

Conclusion:

For further information regarding employee benefits and the hiring process, please refer to the appropriate sections provided by DHCS.



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