Policy and Network Adequacy Lead (Health Program Specialist II)

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: Under the general direction of the Manager II, Branch Chief, Eligibility Policy II Branch, the Health Program Specialist II (HPS II) serves as the lead specialist for the development, implementation, and policy consultation regarding the federal Medicaid rules. The HPS II must routinely demonstrate a high degree of independence, initiative, organization, and take actions that have broad implications on a variety of complex health programs and project activities; work effectively with various health disciplines, government agencies, contractors and advocates in implementing and updating Medi-Cal policy; track and monitor the project management activities associated with the implementation and updating of Medi-Cal policy; research, develop, and facilitate Medi-Cal eligibility policy trainings for internal and external audiences; mentor analyst staff within the Branch on project management, policy development, and system implementations; and serve as a technical program expert to higher level management and represent the department's position in public forums. The HPS II will provide expert consultation services to Unit, Section, Branch and Division staff, executive management team members and advocates, on implementation of new Medi-Cal eligibility policies and applying changes to existing Medi-Cal eligibility policies for the Division and other divisions within the Department of Health Care Services (DHCS), county human service departments and the public. The HPS II will lead workgroups with various external stakeholders, the Centers for Medicare and Medicaid as well as internal staff and executive management. The HPS II represents DHCS in workgroups and meetings with Covered California, California Healthcare Eligibility Enrollment and Retention System (CalHEERS), the Statewide Automated Welfare Systems (SAWS), county human services departments, and the County Welfare Directors Association (CWDA) in the development and implementation of uniform eligibility and enrollment policies and procedures. The HPS II will perform the assigned duties proficiently with minimal supervision, exercising considerable independent judgment in providing policy and procedural recommendations that have significant impact on California's Medi-Cal program. The recommendations of this HPS II will affect county government operations and finances, and the health and welfare of the beneficiary population. The HPS II will have a thorough knowledge and understanding of state Medi-Cal eligibility laws and regulations, as well as remain up-to-date with the frequent changes occurring in the program. Instate travel and overnight stays may be required five percent or less of the time. 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 not eligible for a visa sponsorship. Applicants must be authorized to work in the US without the need for a visa sponsorship by the start date of employment. NOTE: To be considered for this Job Opportunity, applicants must have permanent civil service status, be reachable on an employment list, have transfer eligibility, or have reinstatement eligibility. IF YOU DO NOT HAVE ELIGIBILITY, YOU MUST TAKE THE EXAM. Please visit the CalCareers website to take the exam for this classification. Health Program Specialist II (HPS II) Exam Link You will find additional information about the job in the Duty Statement. 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: • Previous experience mentoring staff. • Basic knowledge of Medi-Cal eligibility rules. • Experience with providing policy technical support for automation changes. • Experience leading internal and external workgroups. • Ability to work independently and as part of a team. • Analytical and research skills (ability to analyze complex situations and provide recommendations). Effective communication skills (both written and verbal). • Strong project management skills. • Experience implementing significant policy and system changes.