Nurse Evaluator IV (Nurse Evaluator II, Health Services)

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, as well as through collaboration with the federal government and other state agencies, counties, and partners, in caring for low-income families, children, pregnant women, older adults, and individuals 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: Under the direction of the Manager II, Branch Chief, the Nurse Evaluator IV (NE IV) is responsible for a wide variety of complex administrative, supervisory, and day-to-day management tasks for a multidisciplinary staff in the Clinical Assurance Division (CAD). The incumbent will have oversight with managing the Designated Public Hospitals (DPH) and Diagnosis Related Group (DRG) Treatment Authorization Request (TAR)-Free post-paid claims. The NE IV oversees compliance reviews of DPH and DRG hospitals utilization management determined by medical necessity to ensure hospital compliance with Medi-Cal policy, regulations, and program procedures. This position requires a board spectrum of clinical knowledge and experience as well as Medi-Cal program knowledge. 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 Form 700 within 30 days of appointment and once per year. Failure to comply with the Conflict of Interest Code requirements may void the appointment. This advertisement is posted as until filled. Applications will be reviewed: 10/2/2026, 10/23/26, 11/6/2026, 11/20/2026, 12/4/2026, 12/18/2026, 1/4/2027, 1/28/27, 2/12/27, 2/26/27, and 3/12/2027. SPECIAL NOTE: Temporary Authorization Appointment (TAU) appointments may be considered for this vacancy, and such appointments may become permanent provided the selected candidate obtains a reachable rank on the associated examination. Please see below "Who May Apply" section for more information. You will find additional information about the job in the Duty Statement. Special Requirements Simple Application Steps If you are interested in this position, complete the following simple steps: • Review the education and experience minimum qualifications (MQ’s) of the Nurse Evaluator IV (8149). • Complete the state application by clicking “Apply Now” above. See below for detailed application instructions. • Submit your application package with all required documents - see the "Required Application Package Documents" section below. 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: • Management and leadership experience overseeing, training, planning and directing the workload of nurses. • Ability to provide clear, concise, and effective written documentation and oral presentation. • Ability to develop and maintain cooperative working relationships, and deal tactfully, professionally, and confidentially with all internal and external customers and contacts. • Ability to adapt behavior and work methods in response to new information, changing conditions or unexpected obstacles. • Ability to take initiative, and work both independently and in a team environment. • Demonstrated ability to lead and motivate staff and provide high-quality customer service in a positive work environment. • Strong organizational and interpersonal skills.