Job Posting: Health Program Audit Manager I - Special Investigations Unit

Department of Health Care Services

JC-328642
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Health Program Audit Manager I - Special Investigations Unit
HEALTH PROGRAM AUDIT MANAGER I, DEPARTMENT OF HEALTH SERVICES

$6,932.00 - $9,047.00 per Month

Final Filing Date: 10/3/2022

Job Description and Duties

The incumbent manages and supervises a multidiscipline staff comprised of auditors, health professionals, and analytical staff established to investigate Medi-Cal fraud, and to develop the basis for the sucvcessful prosecution of said fraud, across the Medi-Cal program areas including but not limited to: Clinics, Federally Qualified Health Centers, Drug Medi-Cal, Skilled Nursing Homes, Narcotic Treatment Providers, Mental Health, Home Health, Hospice, and Pharmacies. Manages and supervises audit staff in the performance of field audits which involve complex fiscal, compliance, and management aspects of health care delivery systems. Assigns the audits, approves pre-onsite audit plans, oversees onsite reviews, oversees post onsite audit activity, reviews work papers, develops and improves audit programs, reviews audit reports prior to submission to Section Chief to ensure reports are complete, accurate, clear and grammatically correct. Up to 15% of Statewidce extended travel and overnight stays may be required. 

You will find additional information about the job in the Duty Statement.

Working Conditions

Regular or recurring telework may occur as part of the incumbents ongoing regular schedule per DHCS’s Telework Policy, in accordance with Government Code Sections 14200 – 14203. This is a hybrid remote centered position 3+ days at home/remote.

The California Department of Human Resources (CalHR) has implemented the requirement that all state employees attest to their vaccination status. Employees are required to indicate whether they are vaccinated, unvaccinated, or if they choose not to disclose their vaccination status. As an additional health and safety standard to protect the state workforce and the public it serves, CalHR is also implementing COVID-19 testing of all state employees working on site (including field sites) if they are unvaccinated, vaccinated but choose not to provide documentation, or choosing not to disclose their vaccination status. Any employee seeking exemption from COVID-19 testing or wearing a face covering must provide evidence of vaccination. This requirement is subject to change depending upon updated Federal, State, and/or local requirements and guidance.

Minimum Requirements

You will find the Minimum Requirements in the Class Specification.

Position Details

Job Code #:
JC-328642
Position #(s):
806-010-4247-xxx
Working Title:
Health Program Audit Manager I - Special Investigations Unit
Classification:
HEALTH PROGRAM AUDIT MANAGER I, DEPARTMENT OF HEALTH SERVICES
$6,932.00 - $9,047.00
# of Positions:
1
Work Location:
Sacramento County
Job Type:
Permanent, Full Time

Department Information

DHCS is California’s health care safety net, helping millions of low-income and disabled Californians each and every day.

The mission of DHCS is to provide Californians with access to affordable, integrated, high-quality health care, including medical, dental, mental health, substance use treatment services and long-term care. Our vision is to preserve and improve the overall health and well-being of all Californians.
Audits and Investigations Division (A&I) is the designated Program Integrity Unit (PIU) for the Medi-Cal program. A&I's mission is to protect and enhance the integrity of the health programs administered by the Department of Health Care Services (DHCS). A&I also strives to improve the effectiveness and efficiency of DHCS and the programs it administers.

The Special Investigations Unit is a multi-disciplinary team that conducts targeted post payment reviews of Medi-Cal providers identified as having potential fraud, waste and abuse billings.

DHCS is a dynamic department with ambitious goals and talented, committed employees. We work hard every day to fulfill our vital responsibility to support the delivery of quality health care to Californians. DHCS is committed to addressing disparities within our organization and in our communities though efforts toward greater diversity, equity, and inclusion. This is accomplished, in part, by a commitment toward employing a diverse workforce which reflects the many communities we serve, and by promoting and enforcing equal employment opportunity. 

Special Requirements

*To be considered for this Job Opportunity, applicants must have permanent civil service status, be reachable on an employment list, or have transfer eligibility. IF YOU DO NOT HAVE ELIGIBILITY, YOU MUST TAKE THE EXAM.*


Staff Management Auditor is the appropriate class for the Health Program Audit Manager I:  https://jobs.ca.gov/CalHrPublic/Exams/Bulletin.aspx?examCD=0PBCF

 

Special Requirements: This position is designated under the Conflict of Interest Code. The position is responsible for making or participating in the making of governmental decisions that may potentially have a material effect on personal financial interests. The appointee is required to complete a Statement of Economic Interests (Form 700) within 30 days of assuming office, annually by April 1st, and within 30 days of leaving office.

Application Instructions

Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.

Final Filing Date: 10/3/2022

Who May Apply

Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates apply.

Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process.
Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).

How To Apply

Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at www.CalCareers.ca.gov. When submitting your application in hard copy, a completed copy of the Application Package listing must be included. If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below:

Address for Mailing Application Packages

You may submit your application and any applicable or required documents to:

Department of Health Care Services
Attn: Certification Technician
M.S. 1300
P.O. Box 997411
Sacramento, CA 95899-7411

Address for Drop-Off Application Packages

You may drop off your application and any applicable or required documents at:

Department of Health Care Services
1501 Capitol Avenue, Suite 71.1501
Sacramento, CA 95814
08:00 AM - 05:00 PM

Required Application Package Documents

The following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:

  • Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at www.CalCareers.ca.gov. All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
  • Degree and/or School Transcripts
  • Statement of Qualifications -

    The Statement of Qualifications (SOQ) should be no more than 2 pages in length (one and a half space, 1 inch left and right margins, and a font size comparable to Arial 12 point). NOTE: A resume is optional and does not take the place of the SOQ. Applications received without a SOQ will not be considered:

    Please describe your experience and education as it relates to job duties.
Applicants requiring reasonable accommodations for the hiring interview process must request the necessary accommodations if scheduled for a hiring interview. The request should be made at the time of contact to schedule the interview. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this job posting.

Desirable Qualifications

In addition to evaluating each candidate's relative ability, as demonstrated by quality and breadth of experience, the following factors will provide the basis for competitively evaluating each candidate:

This position requires the incumbent maintain consistent and regular attendance; communicate effectively, orally and in writing, in dealing with the public and/or other employees; develop and maintain knowledge and skill related to specific tasks, methodologies, materials, tools and equipment; complete assignments in a timely and efficient manner; and, adhere to departmental policies and procedures regarding attendance, leave, and conduct.

Per CCR 249.3, this job control may be used to fill subsequent vacancies.

Benefits

https://jobs.ca.gov/CalHrPublic/GeneralInfo/WhyWorkForTheStateOfCalifornia.aspx

From entry-level jobs to student opportunities to full career paths, the state of California offers a wide variety of opportunities for job applicants. The state offers comprehensive benefits for its employees, who provide essential and exceptional service to millions of Californians every day.

http://www.calhr.ca.gov/employees/Pages/new-employee-benefits-orientation-step-1.aspx

Contact Information

The Hiring Unit Contact is available to answer questions regarding the position or application process.

Hiring Unit Contact:
Joe Keefe
(916) 750-1163
joe.keefe@dhcs.ca.gov

Please direct requests for Reasonable Accommodations to the interview scheduler at the time the interview is being scheduled. You may direct any additional questions regarding Reasonable Accommodations or Equal Employment Opportunity for this position(s) to the Department's EEO Office.

EEO Contact:
EEO Officer
(916) 440-7370
civilrights@dhcs.ca.gov
California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device.

Equal Opportunity Employer

The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.

It is an objective of the State of California to achieve a drug-free work place. Any applicant for state employment will be expected to behave in accordance with this objective because the use of illegal drugs is inconsistent with the law of the State, the rules governing Civil Service, and the special trust placed in public servants.

Application Methods:
Electronic (Using your CalCareer Account)
By Mail
Drop-off