NURSE EVALUATOR IV, 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:

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 be charged specifically with managing the utilization review process for services requested by Medi-Cal providers on a Treatment Authorization Request (TAR) form. TARs and supporting documentation are reviewed and adjudication based on broad medical criteria and professional judgment by a staff of Nurse Evaluators and Medical Consultants. The NE IV oversees the authorization of medically necessary services to Medi-Cal eligible fee-for-service beneficiaries using the least costly alternative to meet their medical needs. The incumbent will ensure that TAR decisions are consistent and that Medi-Cal policies and regulations are uniformly applied. This position requires a broad spectrum of clinical knowledge and experience as well as Medi-Cal program knowledge. Travels to attend meetings and/or conduct provider/staff training.

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 recruitment is until filled and applications will be reviewed on a bi-weekly basis. The cutoff dates will be: September 17, 2026, September 30, 2026, October 15, 2026, October 30, 2026, November 12, 2026, November 26, 2026, December 17, 2026, December 31, 2026, January 14, 2027, January 28, 2027, February 11, 2027, and February 25, 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 .

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 simple steps:

1. Review the education and experience minimum qualifications (MQ’s) of the Nurse Evaluator IV (8149) .
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.

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. Temporary Appointments may be considered if conditions warrant. Temporary Appointments may be made to anyone regardless of eligibility. Temporary Appointments may not exceed 9 months and will require eligibility to be obtained through an examination process in order to transition to a permanent appointment.

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-530058

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-530058

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.

The DHCS office location for this position may be located in West Sacramento, San Francisco, Los Angeles, Rancho Cucamonga, and San Diego.

For a list of possible DHCS office assignment locations, please reference the reporting location document attached to the duty statement on this job advertisement.

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.