California Department of Health Care Services
Nurse Evaluator II
California Department of Health Care Services, California, Missouri, United States, 65018
Overview
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The Nurse Evaluator II is a California Department of Health Care Services (DHCS) role responsible for performing adjudication of Treatment Authorization Requests (TARs) and utilization review and post-claims oversight for services rendered to Medi-Cal beneficiaries. This position is statewide with potential telework options and locations including West Sacramento, San Francisco, San Bernardino, San Diego, and Los Angeles.
Responsibilities
Adjudicate Treatment Authorization Requests (TARs).
Conduct utilization review and post-claims oversight for Medi-Cal services.
Monitor and ensure compliance with program requirements and applicable policies.
Collaborate with internal teams and external stakeholders to ensure timely and accurate determinations.
Perform related duties as assigned within the classification.
Minimum Requirements You will find the Minimum Requirements in the Class Specification. The following items are typically part of the recruitment process for Nurse Evaluator II:
NURSE EVALUATOR II, HEALTH SERVICES (minimum qualifications in the class specification).
Salary and Benefits Base pay range and pay information are provided by DHCS. New state candidates are hired at the minimum salary of the classification or the minimum of the alternate salary range when applicable. The posted salary range is $7,430.00 – $9,757.00. Telework and salary information details are available in the Telework and Salary Information section of the posting.
Medical, dental, and vision insurance
Paid holidays and vacation/leave
Defined retirement program
Savings Plus Program (401(k), 457)
Medical/Dependent Care Reimbursement Accounts
Working Conditions Statewide recruitment; telework may be available up to five days a week at the department's discretion. The selected candidate will be assigned to a DHCS office near their residence and may be required to report to other DHCS locations as needed. Travel reimbursements follow bargaining unit provisions.
Application Process
Review the education and experience minimum qualifications for the Nurse Evaluator II.
Complete the state application by clicking “Apply Now.”
Submit your application package with all required documents (see required documents section).
After applying, take the Nurse Evaluator II examination. See the posted Exam Bulletin.
Statement of Qualifications (SOQ) and Required Documents Applicants must include a Statement of Qualifications (SOQ) describing how their skills and experience qualify them for the position. The SOQ is a narrative; resumes do not replace the SOQ. The SOQ should be 12-point Arial font, single-spaced, with your first and last name in the top right corner, and no more than two pages. Include responses to the required questions as part of the SOQ. AI-generated responses will not be accepted.
How to Apply
Submit the Application Package electronically via CalCareers.ca.gov or by mail/hand delivery to the Department of Health Care Services (address details provided in the posting).
Include all required documents: STD 678 (or electronic application), resume (optional), and SOQ with the required responses.
Equal Opportunity Employer The State of California is an equal opportunity employer. It is the policy of the State to provide equal opportunity irrespective of age, ancestry, color, disability, gender, gender identity, genetic information, marital status, medical condition, national origin, political affiliation, race, religion, sex, or sexual orientation. Reasonable accommodations are available for the hiring interview process.
Contact Information Hiring Unit Contact: Lani Su — (916) 398-3216 — lani.su@dhcs.ca.gov
Telework and Location Information This position is field-based and may be eligible for telework up to five days a week. The selected candidate must report to their assigned DHCS office and may be required to travel to other DHCS locations. Residency verification may be required.
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The Nurse Evaluator II is a California Department of Health Care Services (DHCS) role responsible for performing adjudication of Treatment Authorization Requests (TARs) and utilization review and post-claims oversight for services rendered to Medi-Cal beneficiaries. This position is statewide with potential telework options and locations including West Sacramento, San Francisco, San Bernardino, San Diego, and Los Angeles.
Responsibilities
Adjudicate Treatment Authorization Requests (TARs).
Conduct utilization review and post-claims oversight for Medi-Cal services.
Monitor and ensure compliance with program requirements and applicable policies.
Collaborate with internal teams and external stakeholders to ensure timely and accurate determinations.
Perform related duties as assigned within the classification.
Minimum Requirements You will find the Minimum Requirements in the Class Specification. The following items are typically part of the recruitment process for Nurse Evaluator II:
NURSE EVALUATOR II, HEALTH SERVICES (minimum qualifications in the class specification).
Salary and Benefits Base pay range and pay information are provided by DHCS. New state candidates are hired at the minimum salary of the classification or the minimum of the alternate salary range when applicable. The posted salary range is $7,430.00 – $9,757.00. Telework and salary information details are available in the Telework and Salary Information section of the posting.
Medical, dental, and vision insurance
Paid holidays and vacation/leave
Defined retirement program
Savings Plus Program (401(k), 457)
Medical/Dependent Care Reimbursement Accounts
Working Conditions Statewide recruitment; telework may be available up to five days a week at the department's discretion. The selected candidate will be assigned to a DHCS office near their residence and may be required to report to other DHCS locations as needed. Travel reimbursements follow bargaining unit provisions.
Application Process
Review the education and experience minimum qualifications for the Nurse Evaluator II.
Complete the state application by clicking “Apply Now.”
Submit your application package with all required documents (see required documents section).
After applying, take the Nurse Evaluator II examination. See the posted Exam Bulletin.
Statement of Qualifications (SOQ) and Required Documents Applicants must include a Statement of Qualifications (SOQ) describing how their skills and experience qualify them for the position. The SOQ is a narrative; resumes do not replace the SOQ. The SOQ should be 12-point Arial font, single-spaced, with your first and last name in the top right corner, and no more than two pages. Include responses to the required questions as part of the SOQ. AI-generated responses will not be accepted.
How to Apply
Submit the Application Package electronically via CalCareers.ca.gov or by mail/hand delivery to the Department of Health Care Services (address details provided in the posting).
Include all required documents: STD 678 (or electronic application), resume (optional), and SOQ with the required responses.
Equal Opportunity Employer The State of California is an equal opportunity employer. It is the policy of the State to provide equal opportunity irrespective of age, ancestry, color, disability, gender, gender identity, genetic information, marital status, medical condition, national origin, political affiliation, race, religion, sex, or sexual orientation. Reasonable accommodations are available for the hiring interview process.
Contact Information Hiring Unit Contact: Lani Su — (916) 398-3216 — lani.su@dhcs.ca.gov
Telework and Location Information This position is field-based and may be eligible for telework up to five days a week. The selected candidate must report to their assigned DHCS office and may be required to travel to other DHCS locations. Residency verification may be required.
#J-18808-Ljbffr