Managed Care Policy Specialist

Work Location Sacramento County 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. About this Role Under the general direction of the Supervisor II of the Policy and External Complaints Section, the Health Program Specialist II (HPS II) exercises a large degree of independence in serving as the subject matter expert (SME) on the H.R. 1 member cost sharing requirements within the Medi-Cal managed care program. This position is responsible for cross-divisional coordination, collaboration with internal staff and external stakeholders to develop and implement compliance processes and policy. The HPS II provides policy consultation and technical assistance to departmental staff and Medi-Cal Managed Care Plans (MCPs) and supports the development of guidance documents, including All Plan Letters (APLs), Frequently Asked Questions (FAQs), and training materials. The HPS II monitors MCP adherence with issued policy, identifying areas for improvement or clarification, and MCP compliance with any reporting requirements necessary to meet federal obligations. This is a highly skilled program consultant in the area of policy development and interpretation and has a lead responsibility over developing and writing policy, procedural review tools, and reviewing MCP procedure submissions. The HPS II performs functions that are sensitive and critical to the Department's mission, with responsibility to coordinate the development of broad policy that has multi-divisional, immediate, and long-range impacts, and where the level of expertise required is substantially greater than that of other nonsupervisory positions. This position has been advertised as limited term and is expected to last 12 months. This limited term position may be extended up to 24 months if supported by workload or may become permanent if workload becomes permanent. You will find additional information about the job in the Duty Statement. Working Conditions Please see the Telework and Salary Information section below for telework, reporting location, and temporary statewide salary reduction details. Minimum Requirements

HEALTH PROGRAM SPECIALIST II

Additional Documents Job Application Package Checklist Duty Statement Position Details Job Code #: JC-526071 Position #(s): 805-147-8336-XXX Working Title: Managed Care Policy Specialist Classification: HEALTH PROGRAM SPECIALIST II $7,276.00 - $9,107.00 # of Positions: Multiple Work Location: Sacramento County Telework: Hybrid Job Type: 12 Month Limited Term - Full Time Department Information DHCS’ purpose 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. Take a look at some of DHCS' recent projects and happenings that our Department has accomplished in the DHCS Newsroom. Desirable Qualifications Maintain consistent and regular attendance Communicate effectively (orally and in writing if both appropriate) in dealing with the public, MCP representatives, stakeholders, legislative representatives, and/or other employees Develop, maintain, and enhance knowledge and skills related to specific tasks Research, methodologies, federal and state law, program policy, materials, tools, and equipment Complete assignments in a timely and efficient manner; and, adhere to departmental policies and procedures regarding attendance, leave, and conduct 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 DHCS 2023-2027 Strategic Plan provides more information about our commitment to serving Californians and organizational excellence. We need your help! Please let us know how you heard about our position by taking this brief optional survey: SurveyMonkey link . This survey is not required to be considered for this position. Contact Information The Hiring Unit Contact is available to answer questions regarding the position or application process. Hiring Unit Contact: Emilie Correa View phone number on click.appcast.io View email address on click.appcast.io 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 View phone number on click.appcast.io View email address on click.appcast.io California Relay Service: View phone number on click.appcast.io (TTY), View phone number on click.appcast.io (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device. Telework and Salary Information Telework: This position is currently eligible for telework. 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. Beginning July 1, 2026, pursuant to Executive Order N-22-25 issued March 3, 2025, and California Department of Human Resources (CalHR) Statewide Guidance issued March 13, 2025, DHCS team members generally will be required to report in person a minimum of four days per week unless exempted/excepted. 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 1501 Capitol Ave, Sacramento, CA 95814. Salary: 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. Please reach out to the hiring unit contact listed on this job advertisement for details. Additional Information This recruitment may be used to fill other vacancies. 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. #J-18808-Ljbffr California Department of Health Care Services