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Medicaid Compliance Specialist II
2 months ago
Position Overview
This role is subject to HR and Budget approvals.
Under the guidance of the Staff Services Manager III (SSM III), the Health Program Specialist II (HPSII) within the Medi-Cal Eligibility Division (MCED), Program Review Branch (PRB), exhibits a significant level of autonomy, initiative, and innovation in executing responsibilities. The HPS II collaborates with PRB leadership and personnel, federal and state regulatory bodies, the County Welfare Director's Association, advocacy organizations, private contractors, and various divisions within the Department of Health Care Services (DHCS).
The HPS II engages with the Branch's County Oversight and Monitoring Section (COMS) on federal and state audits conducted by oversight agencies. This encompasses the triennial Payment Error Rate Measurement (PERM) review and the Medi-Cal Eligibility Quality Control pilot initiatives. The HPSII is tasked with assisting in the preparation of reports mandated by these programs and is responsible for addressing inquiries from external auditors.
Additionally, the HPS II will support the reinitiation of county-focused reviews and disseminate new oversight and monitoring activities stemming from the California Advancing and Innovating Medi-Cal (CalAIM) initiative to DHCS' business partners and stakeholders. The role requires direct collaboration with the COMS section chief on special projects assigned to the section. This position necessitates a comprehensive understanding of the Medicaid program and familiarity with federal and state auditing standards.
Due to the nature of the responsibilities, travel may be required to attend meetings and/or conduct training sessions for providers and staff, with overnight stays potentially necessary. Travel is anticipated to be 10 percent or less of the time.
Why Join DHCS?
The Department of Health Care Services (DHCS) serves as the foundation of California's health care safety net. Our achievements are driven by the dedication of over 4,800 DHCS team members and through partnerships with the federal government, state agencies, counties, and stakeholders committed to the care of low-income families, children, pregnant women, older adults, and individuals with disabilities. This is a remarkable opportunity to become part of our diverse team in this capacity.
Working Conditions
For details regarding telework, please refer to the Telework Information section.
Employee Benefits Overview
As a new State Civil Service employee, you will have access to a comprehensive benefits package, including health, dental, and vision insurance, retirement plans, and various voluntary benefits designed to support your financial and personal well-being.
For further information regarding specific benefits, please consult the relevant sections on the benefits overview.
