Nurse Evaluator II

Nurse Evaluator II

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 click.appcast.io 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 700 within 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: 05/29/2026, 06/29/2026, and 7/29/2026.

You will find additional information about the job in the Duty Statement.