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 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 direction of the Nurse Evaluator III in the Department of Health Care Services' (DHCS) Clinical Assurance Division (CAD), the Nurse Evaluator II (NE II) performs professional nursing duties as part of the medical review team, including utilization review, post-claims oversight, and adjudication of Treatment Authorization Requests (TARs) to ensure services provided to Medi-Cal beneficiaries meet medical necessity and comply with Medi-Cal policy. The NE II reviews patient histories and medical records, prepares draft reports and responses for fair hearings, and provides guidance to providers, beneficiaries, and other Department and government staff on medical policies and procedures.

Travel statewide, including overnight, of up to 5% of the time, by airplane, train, automobile, and other transportation methods is required to perform job related tasks such as attend meetings and conduct provider outreach. Travel related duties are dependent upon workload and operational need.

New to state candidates will be hired into the minimum salary of the classification or minimum of the alternate salary range when applicable. Placement to alternate range may be based on education or experience identified in your state application.

Examination Information: In order to be considered for the vacancy, all candidates must be eligible for appointment. For your convenience, here is the link on how to take the Nurse Evaluator II: 

If you already have list eligibility for this classification, you do not need to retake the examination, except when your list eligibility expires. For questions regarding the examination process, please send an email to: View email address on us.fitly.work

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 700within 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.

You will find additional information about the job in the .

Minimum Requirements

You will find the Minimum Requirements in the Class Specification.

Additional Documents

Special Requirements

Simple Application Steps

If you are interested in this position, complete the following these simple steps:

1. Review the education and experience minimum qualifications (MQ’s) of the Nurse Evaluator II . See the Minimum Requirements section above.
2. Complete the state application by clicking “Apply Now” above. See below for detailed application instructions.
3. Submit your application package with all required documents - see the "Required Application Package Documents" section below.
4. Once you have applied, take the Nurse Evaluator II examination. See the link to Nurse Evaluator II Exam Bulletin .

Application Instructions

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: Until Filled

Who May Apply

Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list or LEAP eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates apply.

Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process. Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).

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 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

Mailing

Attn: Certification Technician JC-532338

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

Drop-Off

Certification Section JC-532338

1501 Capitol Avenue, Suite 71.1501

Sacramento , CA 95814

Monday – Friday (excluding holidays)

08:00 AM - 04:00 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 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.

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.

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 

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: . 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:
Lani Su
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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
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California Relay Service: View phone number on us.fitly.work (TTY), View phone number on us.fitly.work (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.

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.

Personal Leave Program (PLP) 2025 agreement

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.