Health Program Auditor I

2 months ago


Sacramento, 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 Health Program Auditor I to join our team. As a key member of our team, you will be responsible for conducting administrative appeals, ensuring the fairness and efficiency of the process, and making sound decisions based on complex laws, regulations, and departmental policies.

Key Responsibilities:
  • Conduct administrative appeals, including matters related to cost report audits, Medi-Cal provider enrollment, and direct care service hours per patient day audits.
  • Develop, implement, and perform appeal procedures for new types of appeals.
  • Work with internal and external parties, including company executives, attorneys, county officials, and program administrators, to interpret their arguments and make decisions.
  • Write sound decisions that are grammatically correct and consistent with laws and regulations.
  • Review internal controls, organizational policies, and procedures, and make suggestions for improvement.
Requirements:
  • Minimum qualifications of both the Staff Management Auditor and Health Program Audit Manager I classifications.
  • Ability to work with complex laws, regulations, and departmental policies.
  • Strong analytical and decision-making skills.
  • Excellent communication and interpersonal skills.
What We Offer:

As a member of our team, you will have the opportunity to work in a dynamic and challenging environment, with a competitive salary and benefits package. You will also have the chance to develop your skills and expertise in a field that is critical to the health and well-being of Californians.



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