Chief Clinical Assurance Division Lead

3 weeks ago


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

The Department of Health Care Services is seeking a highly skilled and experienced professional to serve as the Chief, Clinical Assurance Division (CAD). This is a Career Executive Assignment Level B position that requires strong leadership and management skills, as well as expertise in clinical assurance and utilization management.

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.
  • Administer Treatment Authorization Requests (TARs) and the TAR-free program.
  • Oversee post-payment utilization control of Medi-Cal benefits.
  • Develop and implement policies and procedures to ensure compliance with state and federal regulations.
  • Collaborate with stakeholders to identify and address clinical assurance and utilization management issues.
Requirements:
  • Master's degree in a related field, such as health care administration or public health.
  • At least 5 years of experience in clinical assurance and utilization management, with a focus on Medi-Cal programs.
  • Strong leadership and management skills, with experience leading cross-functional teams.
  • Excellent communication and interpersonal skills, with the ability to work effectively with stakeholders at all levels.
  • Knowledge of state and federal regulations related to health care and utilization management.
What We Offer:
  • A competitive salary and benefits package.
  • The opportunity to work in a dynamic and fast-paced environment.
  • The chance to make a meaningful contribution to the health and well-being of California's residents.


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