Health Program Auditor IV (Hybrid Option)

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. Job Description And Duties The HPA IV functions as a program specialist and performs other audit activities. The Health Program Auditor (HPA) IV is the most advanced auditor level and is considered the Section specialist. The HPA IV is a promotional position and requires knowledge of Medi‑Cal reimbursement and candidates must possess this valuable knowledge. Travel of up to 15% is routinely required and may include overnight, and / or weekend stays. Working Conditions Please see the Telework and Salary Information section below for telework, reporting location, and temporary statewide salary reduction details. Minimum Requirements You will find the Minimum Requirements in the Class Specification. HEALTH PROGRAM AUDITOR IV, DEPARTMENT OF HEALTH SERVICES Additional Documents Job Application Package Checklist Duty Statement Position Details Job Code #: JC-536257 Position #(s): View phone number on click.appcast.io-XXX Working Title: Health Program Auditor IV (Hybrid Option) Classification: HEALTH PROGRAM AUDITOR IV, DEPARTMENT OF HEALTH SERVICES Salary: $6,955.00 - $9,142.00 New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable. # of Positions: Multiple Work Location: Sacramento County Telework: Hybrid Job Type: Permanent, Full Time Department Information DHCS’ purpose is to provide equitable access to quality health care leading to a healthy California for all. 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. Audits and Investigations (A&I) is the designated Program Integrity Unit for California’s Medicaid program – Medi‑Cal. A&I’s mission is to protect and enhance the integrity of the health programs administered by DHCS. To carry this out, A&I performs financial and compliance audits, including post-service post-payment utilization reviews, of Medi‑Cal providers; performs compliance and medical audits of medical, dental and behavioral health managed care plans; identifies and investigates Medi‑Cal provider and beneficiary fraud, waste, and abuse, emphasizing fraud prevention; ensures accountability of state and federal health care funding by recovering identified overpayments; performs onsite reviews as part of the Medi‑Cal provider enrollment process; provides technical assistance (financial and medical) for the development and enhancement of DHCS health programs and related policy; and provides technical assistance and audited data to support health care financing initiatives and objectives such as provider rate setting. Financial Review Outpatient and Behavioral Health Division (FROBHD) conducts financial and compliance reviews and audits of Medi‑Cal and other DHCS programs’ outpatient and behavioral health providers to verify payments to providers of services to Medi‑Cal beneficiaries and reported costs are valid, accurate and in compliance with governing laws, regulations, and program intent. Audited data is also provided to assist with provider rate setting purposes. Provider types and programs audited include Federally Qualified Health Centers, Rural Health Clinics, Local Educational Agency, Targeted Case Management, Ground Emergency Medical Transportation, Specialty Mental Health, Substance Abuse Prevention and Treatment Block Grant, and Drug Medi‑Cal Organized Delivery System. FROBHD/Outpatient Financial Review Branch/Special Programs Section - is seeking a candidate to join as an Health Program Auditor IV position. Please direct all questions to the hiring unit contact listed in this job posting. Education Education: If you are meeting minimum qualifications with education, you must include a copy of your diploma/degree and/or unofficial/informal transcripts for verification. Official transcripts may be required upon appointment. 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. Individuals who are eligible for a Training and Development assignment may also be considered for this position(s). 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). Final Filing Date: 11/9/2026 Required Application Package Documents 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. Degree and/or School Transcripts Applicants requiring reasonable accommodations for the hiring interview process Applicants who require 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. 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: This position requires the incumbent to have and maintain good rapport, consistent and regular attendance, communicate effectively both orally and in writing in dealing with the public and/or other employees. Please indicate your eligibility in the area of the application where you enter the position name and number for which you are applying. Extensive knowledge of governmental auditing standards, audit methodologies, and internal control frameworks. Advanced proficiency in planning, conducting, and documenting complex, financial, compliance, performance, and management audits. Strong knowledge of federal and state laws, regulations, policies, and contractual requirements affecting health care programs. Exceptional analytical and critical thinking skills, with the ability to evaluate large and complex data sets and identify significant compliance, fiscal, and operational risks. Demonstrated ability to independently interpret and apply complex regulations, policies, and audit requirement to unique and sensitive situations. Excellent written communication skills, including the ability to prepare clear, concise, and persuasive audit reports, audit appeal position statements, and correspondence. Excellent oral communication and presentation skills, including the ability to effectively discuss findings and recommendations with executive leadership, providers, contractors, and external stakeholders. Experience conducting or supporting audit appeals, administrative hearings, corrective action monitoring, or dispute resolution processes. Ability to mentor and provide technical guidance to auditing staff and serve as a subject matter expert on complex audit and compliance matters. Advanced proficiency with Microsoft Excel and other audit, financial, and data analysis tools. Benefits Continuous and ongoing training Diversity, Equity, and Inclusion program activities Employee Assistance Program (EAP) Professional Competency Pay for Auditors who obtain CPA license or CIA certification Merit Based Promotional opportunities based on performance Training opportunities to support role Upward Mobility 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 Hiring Unit Contact: Brandon Smith 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 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 is Sacramento. 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 Arial Size 3 40 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. 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