Provider Networks Specialist

Job Description and Duties

Under the direction of the Supervisor II in the OPM, Division of Provider Networks (DPN), the Health Program Specialist I (HPS I) performs high profile, sensitive and complex specialized assignments involving broad policy issues, which have significant statewide impact on the Department’s licensing program pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (Act), the California Code of Regulations, Title 28 (Regulations), and program policies and procedures. The incumbent monitors, oversees and ensures that full service and specialized health care service plans comply with the licensing requirements of the Act and Regulations. The incumbent is responsible for performing highly sensitive and complex duties involved in planning, implementing, monitoring and evaluating health program activities within the DPN. The incumbent serves in a lead capacity and as an expert on projects in the program area, performs a broad range of highly technical, consultative and programmatic areas within the OPM.

The incumbent performs research, analyzes and compiles data independently, and drafts written material involving highly complex policy matters. Additionally, the incumbent may formulate recommendations to Department counsel, including Office of Legal Services (OLS), on the drafting of new regulations. The incumbent leads highly complex project management matters that may require inter-divisional workgroups, meetings with outside stakeholders, development of goals with timeframes and production of progress reports to monitor the projects to ensure completion.

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Leave Program (PLP) 2025 agreement:

Effective July 1, 2025, the California Department of Human Resources (CalHR) implemented the temporary Personal Leave Program 2025 (PLP 2025). PLP 2025 directs that each employee receive a temporary reduction in pay in exchange for PLP 2025 leave credits. The temporary salary reduction percentage and the number of PLP 2025 leave credits are based on the position’s associated bargaining unit. The salary range(s) included in this job advertisement do not include the temporary salary reduction.

You will find additional information about the job in the .

Working Conditions

The DMHC has locations in Downtown Sacramento and Rancho Cordova. Both locations are located close to light-rail with various amenities. The incumbent will work in a climate-controlled cubicle and/or office environment with artificial lighting.

This position may be eligible for hybrid telework. The telework schedule is permitted at the operational needs of the Department and is subject to change, consistent with the State Telework Policy and the DMHC’s Telework Policy. All employees who telework are required to be California residents and maintain California residency in accordance with Government Code 14200.

Special Requirements

• The position(s) require(s) a Background Investigation be cleared prior to being hired.

The position(s) require(s) a Background Investigation be cleared prior to being hired.

Any documents you submit for a job vacancy such as your state application, resume, cover letter, educational transcripts, etc. SHOULD NOT include ANY confidential information. Confidential information that should be excluded or removed from these documents include, but is not limited to, your Social Security Number (SSN), birthday, driver’s license number (unless required), basis of eligibility, examination results, LEAP status, marital status, and age. Confidential information on the first page of applications submitted electronically online, such as Easy ID number, SSN, examination related information, and driver’s license number will automatically be redacted upon submission.

Possession of Minimum Qualifications will be verified prior to interview and/or appointment. If you are using education to meet the minimum qualifications for this position, you must submit a copy of your high school transcripts or college/university transcript(s). Unofficial transcripts may be accepted during the application process; however, submission of official transcripts may be required prior to appointment.

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:

• Experience working in the health care industry and/or experience working on health program related projects

• Experience with project management and providing leadership and assistance in developing and implementing new policies and procedures.

• Strong quantitative and qualitative data analysis skills

• Ability to plan, organize, and establish simultaneous workload priorities and work under pressure

• Exercise a high degree of initiative, independence, flexibility, and confidentiality

• Ability to work cooperatively and effectively with others

• Ability to professionally communicate both orally and in writing

• Ability to reason well and use good judgment

• Dependable, punctual, and excellent attendance

• Demonstrated experience using technical software, including, but not limited to: Word, Excel and Access

Benefits

Benefit information can be found on the CalHR website and the CalPERS website.

Additional Application Instructions

To be considered for this vacancy, please complete all applicable fields on the application form, including a list or description of previous/current occupational experience in the duties performed section.

Electronic applications through your CalCareer account are highly recommended.

Do NOT include your social security number on any submitted documents. If submitting your application via postal mail or in person, please notate RPA: 26-004 and Job Control: JC-525007 on your application.

All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to clearly demonstrate how you meet the Minimum Qualifications for the position on your State Application (STD Form 678). The application should also clearly demonstrate the candidate’s ability to meet the Desirable Qualifications identified in this job advertisement. The Classification Specification for the Health Program Specialist I is located at the top of this Job Announcement Posting under Minimum Requirements.

Foreign Degrees or Transcripts – Applicants with foreign degrees or transcripts who wish to apply that coursework toward meeting the minimum qualifications of the classification must provide a transcript evaluation that indicates the number of units to which his/her foreign coursework is equivalent. DMHC accepts foreign transcript evaluations that are completed by one of the agencies approved by the California Commission on Teacher Credentialing .

PLEASE NOTE: If you are mailing your application, it must be postmarked by the final filing date. Hand delivered applications must be submitted no later than 5:00 p.m. on the final filing date. Applications slipped under the door at the Human Resources Office will be time stamped the following business day.

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 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.
• Statement of Qualifications -

  The Statement of Qualifications (SOQ) is a MANDATORY requirement to apply for this position. The SOQ will answer specific questions and provide insight to the hiring manager regarding the candidate’s education, training, experience, and skills to meet the minimum and desirable qualifications for the position.

  Please see section labeled Statement of Qualifications Instructions for further direction .