Job Posting: Chief, Clinical Assurance Division (CEA B)

Department of Health Care Services

JC-435561
-
Chief, Clinical Assurance Division (CEA B)
C. E. A.

$11,435.00 - $13,623.00 per Month

Final Filing Date: 6/26/2024

Job Description and Duties

Why Join DHCS?

The Department of Health Care Services (DHCS) is the backbone of California’s health care safety net. Our success is made possible by the hard work of more than 4,800 DHCS team members and through collaboration with the federal government and other state agencies, counties, and partners for the care of low-income families, children, pregnant women, older adults, and persons with disabilities. This is an exciting opportunity to join our diverse team in the following role. If you are interested in joining our team, apply today!

About this Role:

The Chief, Clinical Assurance Division (CAD), Career Executive Assignment Level B, serves as the principal policymaker and leads 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. Additionally, the Chief CAD, is responsible for the administration of Treatment Authorization Requests (TARs), the TAR-free program, and post-payment utilization control of Medi-Cal benefits.

 

The Chief, CAD, ensures that Division clinical team members authorize requested services that are medically necessary for eligible Medi-Cal members. The Chief, CAD, promotes and leads the development of CAD processes and services and ensures adherence to the Health Insurance Portability and Accountability Act (HIPAA) regarding the protection and release of sensitive and protected health information.

 

The Chief, CAD, provides expert policy guidance on all program matters to DHCS Executive Staff, program partners, and external stakeholders, including, but not limited to, the Legislature, state and federal agencies, and other private and public organizations and advocacy groups. The Chief, CAD, also builds and fosters positive working relationships with Medi-Cal providers.

 

The Chief, CAD, works under the general direction of the Deputy Director, Program Operations, and is a member of DHCS Executive Staff.

 

This position is subject to the Department's Conflict of Interest Code and filing a Statement of Economic Interests (Form 700) upon assuming office, annually by April 1, and upon leaving office.

 

If you are interested in helping Californians by serving as the Chief, CAD, complete and submit the required application package documents and apply today!  

 

Do you have questions and/or need assistance? Contact Executiverecruitment@dhcs.ca.gov. We are here to help you through this Career Executive Assignment hiring process.

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

Working Conditions

Please see the Telework Information section below for telework and reporting location details.

Minimum Requirements

This position does not have a Classification Specification. Requirements and qualifications for this position can be found in this announcement. For additional questions, please contact the hiring department listed below.

    Position Details

    Job Code #:
    JC-435561
    Position #(s):
    808-010-7500-001
    Working Title:
    Chief, Clinical Assurance Division (CEA B)
    Classification:
    C. E. A.
    $11,435.00 - $13,623.00 B
    A salary range of $13,624.00 - $17,855.00 per month is available for candidates who are medical doctors or clinicians.
    # of Positions:
    1
    Work Location:
    Yolo County
    Telework:
    Hybrid
    Job Type:
    Career Executive Assignment - Non Tenured, 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 purpose of DHCS is to provide equitable access to quality health care leading to a healthy California for all.

    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.

    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: 6/26/2024

    Who May Apply

    Individuals who are eligible to be appointed to this Career Executive Assignment (CEA) by the State of California.

    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: Kristin Davis JC #435561
    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
    Kristin Davis JC #435561
    MS 1300
    P.O. Box 997411
    Sacramento, CA 95899-7411
    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.
    • Resume is optional. It may be included, but is not required.
    • Supplemental Application - Responses to the five supplemental questions.
    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.

    Examination Qualification Requirements

    All applicants must possess the knowledge and abilities, and any other requirements, described in this announcement.

    Note: Eligibility to take a CEA examination does not require current permanent status in the civil service.

    General Qualifications

    State civil service employees must possess essential general qualifications including integrity, initiative, dependability, good judgment, and ability to work cooperatively with others.

    Knowledge and Abilities

    Applicants must demonstrate the ability to perform high administrative and policy – influencing functions effectively. Such overall ability requires possession of most of the following more specific knowledge and abilities:

    (1) Knowledge of the organization and functions of California State Government, including the organization and practices of the Legislature and the Executive Branch; principles, practices, and trends of public administration, organization, and management; techniques of organizing and motivating groups; program development and evaluation; methods of administrative problem solving; principles and practices of policy formulation and development; personnel management techniques; the Department’s Equal Employment Opportunity Program (EEO) objectives; and a manager’s role in the EEO.

    (2) Ability to plan, organize, and direct the work of multidisciplinary professional and administrative staff; analyze administrative policies, organization, procedures and practices; integrate the activities of a diverse program to attain common goals; gain the confidence and support of top level administrators and advise them on a wide range of administrative matters; develop cooperative working relationships with representatives of all levels of government, the public, and the Legislature and Executive branches; analyze complex problems and recommend effective courses of action; prepare and review reports; and effectively contribute to the department’s Equal Employment Opportunity objectives.

    These knowledge and abilities are expected to be obtained from the following kinds of experience with substantial participation in the formulation, operation and/or evaluation of program policies (experience may have been paid or volunteer; in State service, other government settings, or in a private organization):

    CEA Level A - Responsible for broad administrative and program activities, including the execution and/or evaluation of program policies.

    CEA Level B - Responsible for extensive managerial and program administration or broad program manager experience with substantial participation in the formulation, operation, and/or evaluation of program policies.

    CEA Level C - Responsible for extensive highly professional influence and contributes to program, policy, and the methods to provide professional services needed to set policies, to meet the mission of the State department and often exercising technical and or professional skills that are required at this level.

    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:
    • Strong leadership, interpersonal, and problem-solving skills.
    • Possession of a medical license is desired but not required.
    • Experience as a medical doctor or clinician.
    • Knowledge and experience in health utilization management.
    • Knowledge of California State Government Administration.
    • Knowledge of the principles, practices, and trends of public administration, organization, and management.
    • Knowledge of health care policy, programs, trends, and issues.
    • Knowledge of the interrelationship of federal, state, local, professional, and voluntary health agencies and the programs and services of such agencies.
    • Demonstrated ability to review legislation and complex, interrelated policies, procedures, and practices.
    • Demonstrated ability to manage and coordinate with large teams in multiple locations.
    • Demonstrated ability to analyze complex problems and develop effective courses of action to solve them.
    • Demonstrated ability to collaborate across high levels of government, external organizations, providers, industry associations, and member representatives.
    • Demonstrated ability to lead change and transformation efforts within and outside the organization, utilizing excellent communication and change management strategies.

    Examination Information

    The examination process will consist of Supplemental Application Items/questions, as outlined below. Applicants must respond to all five supplemental application items for this examination. These supplemental items are designed to identify job achievement in specific areas that demonstrate the ability to perform at the CEA  level B successfully. Responses to the five supplemental application items will be assessed based on pre-determined job-related rating criteria. In appraising the relative qualifications of candidates, consideration will be given to the extent and type of pertinent experience and education over and above that required under the minimum qualifications.

    Each applicant for this examination must complete and submit his/her responses to all five supplemental application items. Supplemental Application Item responses and a completed STD 678 Examination/Employment Application must be postmarked, personally delivered, or received by mail on or before the final filing date. Supplemental Application Item responses may be submitted with an Electronic State Employment Application when applying for this position through your Applicant Account at www.CalCareers.ca.gov.

    APPLICATIONS RECEIVED WITHOUT RESPONSES TO THE SUPPLEMENTAL APPLICATION ITEMS WILL BE REJECTED.

    When responding to the supplemental items, applicants must follow these guidelines:
    • Responses must be typewritten on 8 1/2" x 11" paper, using no smaller than a 12-point font.
    • Responses to the five supplemental application items must be limited to a total of four pages, single-sided. Therefore, the supplemental application document must not exceed four pages.
    • Identify each page with his/her full name.
    • Responses are to be complete, specific, clear, and concise.
    • Answer each numbered item separately, indicating the corresponding item number for each response.
    SUPPLEMENTAL APPLICATION ITEMS
    1. Describe your knowledge and experience regarding the principles and practices of public administration, organization, and management. Include in your response your experience developing policies and programs related to health and human services.

    2. Describe your knowledge and experience in the health care industry, for both public and private sectors. Please include methods used for analyzing and improving managment practices, controls, services, and the customer service experience for health care programs.

    3. Describe your experience implementing a significant change initiative, demonstrating your ability to analyze complex problems and implement effective programs, processes, or technology changes.

    4. Describe your knowledge and experience in the health care field (state, federal, and private), as it relates to the Medi-Cal clinical assurance, utilization management, and treatment authorization processes.

    5. Diversity, equity, and inclusion are a priority at DHCS. The DHCS is actively working to improve the equity of health outcomes for our members and professional opportunities for employees. Provide specific examples of how you addressed inequities in the workplace or in programs and how you have supported diversity, equity, and inclusion for employees.

    If you meet the requirements stated in this announcement, you may take this competitive examination. Possession of the Examination Qualifications requirements does not assure a place on the eligible list. Your performance in the examination will be compared with the performance of others who take this examination, and all successful candidates will be ranked according to their scores.

    A minimum rating of 70% must be attained in the Examination to obtain list eligibility for this position. All candidates will receive written notification of their examination results.

    The results of this examination will only be used to fill this position. Applications will be retained for twelve months.

    Hiring interviews for the Job may be conducted with the most qualified candidates.

    The examining Department reserves the right to revise the examination plan to better meet the needs of the service, if the circumstances under which this examination was planned change. Such revision will be in accordance with civil service law and rules and all competitors will be notified.

    Special Testing Arrangements

    If you have a disability and need special testing arrangements, answer the Reasonable Accommodations question appropriately on your Application (STD 678). You will be contacted to make specific arrangements. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this announcement.

    Benefits

    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

    Full benefits information can be found on CalHR's California State Civil Service Employee Benefits Summary.

    Contact Information

    The Human Resources Contact is available to answer questions regarding the position or application process.

    Human Resources Contact:
    Kristin Davis
    (916) 345-7260
    Kristin.Davis@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.

    Telework Information

    This position may be eligible for telework up to three days per week and requires reporting in person and site-based a minimum of two days per week. The amount of telework is at the discretion of the Department and is subject to change consistent with DHCS’ Telework Program and Government Code sections 14200 – 14203. Telework is available to California residents, and proof of residency may be required.

     

    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.

     

    The DHCS office location for this position is 830 Stillwater, West Sacramento, CA 95605.


    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