Nurse Evaluator II

Work Location Sacramento County Job Description And Duties The Department of Health Care Services (DHCS) is a dynamic organization dedicated to delivering quality health care. We are seeking a Nurse Evaluator II to join the Investigations Division, Audits and Investigations, in the Data Analytics & Case Development Branch. The role uses professional nursing knowledge to perform program integrity functions, including onsite reviews of Medi‑Cal providers, evaluation of medical documentation of services and drugs, and provision of expert medical testimony at administrative appeal and criminal hearings in collaboration with management and legal counsel. Act independently, maintain flexibility, and be tactful in dealings with team members, audit leads, managers, and executive management. Accurately convey medical program integrity findings orally and in written form. Travel up to 10% statewide, including overnight stays, and be available to travel on short notice. Minimum Requirements Holder of an active registered nursing license with the California Board of Registered Nursing and meets the minimum qualifications for the Nurse Evaluator II classification as outlined in the class specification. Desirable Qualifications Strong clinical expertise in fraud, waste, or abuse detection. Regulatory and policy knowledge relevant to Medi‑Cal. Excellent analytical and technical skills, including data competency. Strong communication skills, both written and verbal. Ability to analyze complex clinical and billing information. Enthusiastic, self‑motivated and adaptable. Benefits Medical, dental, and vision insurance. Paid holidays and vacation/leave. Defined retirement program. 401(k) and 457 savings plans. Medical/Dependent Care Reimbursement Accounts. Continuous and ongoing training. Diversity, equity, and inclusion program activities. Employee Assistance Program (EAP). Telework and Salary Hybrid telework model. Salary range $7,430.00 – $9,757.00, effective July 1, 2025, subject to the temporary Personal Leave Program 2025 adjustments. Equal Opportunity Employer The State of California is an equal opportunity employer in accordance with the legal requirements for all applicants, regardless of age, ancestry, color, disability, gender, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sexual orientation, or other protected class. #J-18808-Ljbffr