What are the responsibilities and job description for the NURSE EVALUATOR II, HEALTH SERVICES position at Department of Health Care Services?
Why Join DHCS?
The Department of Health Care Services (DHCS) is a dynamic organization with ambitious goals and talented, committed team members. We work hard every day to fulfill our vital responsibility to support the delivery of quality health care to millions of Californians. This is an exciting opportunity to work in the Contract and Enrollment Reivew Division, Audits and Investigations. Our mission is to protect and enhance the integrity of the health programs administered by DHCS. We are seeking an individual to join our diverse team in the Nurse Evaluator II civil service classification. If you are interested in joining our team, apply today!
Please see the Special Requirements section for simple and easy steps on how to apply for this state position.
About this Role:
The role of the Nurse Evaluator II is to:
To assure the proper and efficient operation of the Medi-Cal Program, the Nurse Evaluator II (NE II) uses professional nursing knowledge, expertise and judgment to perform program integrity functions which include onsite reviews of Medi-Cal providers, evaluation of medical documentation of services and drugs, and provision of expert medical testimony at administrative appeal and criminal hearings in collaboration with management and legal counsel. The incumbent must have the ability to act independently, be flexible, open minded, and tactful in dealing with team members, audit leads and managers, and executive management. The incumbent must be able to accurately convey medical program integrity findings effectively both orally and in written form.Have questions and/or need assistance? Contact Recruit@dhcs.ca.gov, we are here to help walk you through the state hiring process!
This position is subject to the Department’s Conflict of Interest Code and requires annual filing of a Statement of Economic Interests (Form 700).
You will find additional information about the job in the Duty Statement.
Working Conditions
Minimum Requirements
You will find the Minimum Requirements in the Class Specification.- NURSE EVALUATOR II, HEALTH SERVICES
Additional Documents
- Job Application Package Checklist
- Duty Statement
Position Details
Department Information
DHCS is a dynamic organization 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 through efforts toward greater diversity, equity, and inclusion. This is accomplished, in part, by a commitment toward employing a diverse workforce that reflects the many communities we serve, and by promoting and enforcing equal employment opportunity.
Investigations Division (ID) conducts administrative and criminal investigations to address fraud, waste and abuse in Medi-Cal and other DHCS programs. Specific activities include fraud data analytics, Medi-Cal fraud Hotline and complaint intake, investigative audits, provider fraud investigations, and beneficiary fraud investigations.
ID Research is seeking a candidate to join as a Nurse Evaluator II. Please direct all questions to the hiring contact listed in this job posting.
Take a look at some of DHCS' recent projects and happenings that our department has accomplished in the DHCS Newsroom
Special Requirements
If you are interested in this position, complete the following these simple steps:
- Review the education and experience minimum qualifications (MQ’s) of the Nurse Evaluator II classification. See the Minimum Requirements section above.
- Complete an application package and statement of qualifications, if applicable, for this position.
- Submit your application package with all required documents - see Required Application Package Documents section below. .
- Once you have applied, take the Nurse Evaluator II Examination.
At all times it is required that the incumbent maintain a valid and active registered nursing license with the California Board of Registered Nursing.
Education: If you are meeting minimum qualifications with education, you must include a copy of your diploma/degree and/or unofficial/informal transcripts for verification. Official transcripts may be required upon appointment.
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: 8/2/2024Who May 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
Address for Mailing Application Packages
You may submit your application and any applicable or required documents to:
Address for Drop-Off Application Packages
You may drop off your application and any applicable or required documents at:
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.
- Resume is optional. It may be included, but is not required.
Desirable Qualifications
Benefits
The DHCS is dedicated to creating an innovative workplace for its team members that is inclusive, diverse, and interactive! Here are a few of the ways we stay engaged with our team:
- Continuous and ongoing training
- Diversity, Equity, and Inclusion program activities
- Employee Assistance Program (EAP)
Additionally, as a team member of the State of California, you may be eligible for many benefits, such as:
- Medical, including health, dental, and vision insurance
- Paid Holidays and vacation/leave
- Defined retirement program
- Savings Plus Program (401(k), 457)
- Medical/Dependent Care Reimbursement Accounts
DHCS 2023-2025 Strategic Plan provides more information about our commitment to organizational excellence to ensure we meet the needs of our workforce and members.
In addition, DHCS – Audits & Investigations offer:
- Training opportunities to support role
- Upward Mobility
Contact Information
The Hiring Unit Contact is available to answer questions regarding the position or application process.
Hiring Unit Contact:
Labebe Bustamante
(916) 713-8956
Labebe.Bustamante@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.
DHCS Telework Information
Business travel may be required, and reimbursement considers an employee’s designated office and residence subject to regulations and bargaining unit contract provisions. All commute expenses to the reporting location will be the responsibility of the selected candidate.
Additional Information
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.