Provider Networks Specialist

California Department of Managed Health Care; California; Hybride; USD 74 000 - 93 000; Plein temps

Avantages offerts par ce poste

Hybrid telework

Résumé du poste

California Department of Managed Health Care (DMHC) seeks a Health Program Specialist I to lead complex health program projects within the Division of Provider Networks. You will analyze policy issues, draft recommendations for counsel, and coordinate cross-divisional efforts to ensure licensing compliance with the Knox-Keene Act and Regulations.

The role involves independent data analysis, reporting, and progress tracking, with potential for hybrid telework and statewide impact in DMHC programs.

Qualifications

• Experience with project management and providing leadership on health program projects.
• Strong analytical skills for quantitative and qualitative data.
• Ability to draft policy-related written materials and recommendations.
• Effective communication, both oral and written, with diverse stakeholders.
• Ability to manage multiple priorities and work under pressure in a public-sector setting.

Responsabilités

• Lead highly complex health program projects and manage cross-divisional workgroups.
• Research, analyze, and draft material on policy matters for executives and counsel.
• Monitor compliance with Knox-Keene Act and Regulations in health plans.
• Coordinate with outside stakeholders and track project goals and timelines.
• Provide expert guidance on programmatic areas within the Division of Provider Networks.

Connaissances

Project management

Leadership

Data analysis

Policy analysis

Oral and written communication

Description du poste

Job Description And Duties

This is a re-advertisement. If you have previously applied your application is still being considered.

Under the direction of the Supervisor II in the OPM, Division of Provider Networks (DPN), the Health Program Specialist I (HPS I) performs high profile, sensitive and complex specialized assignments involving broad policy issues, which have significant statewide impact on the Department’s licensing program pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (Act), the California Code of Regulations, Title 28 (Regulations), and program policies and procedures. The incumbent monitors, oversees and ensures that full service and specialized health care service plans comply with the licensing requirements of the Act and Regulations. The incumbent is responsible for performing highly sensitive and complex duties involved in planning, implementing, monitoring and evaluating health program activities within the DPN. The incumbent serves in a lead capacity and as an expert on projects in the program area, performs a broad range of highly technical, consultative and programmatic areas within the OPM.

The incumbent performs research, analyzes and compiles data independently, and drafts written material involving highly complex policy matters. Additionally, the incumbent may formulate recommendations to Department counsel, including Office of Legal Services (OLS), on the drafting of new regulations. The incumbent leads highly complex project management matters that may require inter-divisional workgroups, meetings with outside stakeholders, development of goals with timeframes and production of progress reports to monitor the projects to ensure completion.

Leave Program (PLP) 2025 agreement: 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.

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

Working Conditions

The DMHC has locations in Downtown Sacramento and Rancho Cordova. Both locations are located close to light-rail with various amenities. The incumbent will work in a climate-controlled cubicle and/or office environment with artificial lighting. This position may be eligible for hybrid telework. The telework schedule is permitted at the operational needs of the Department and is subject to change, consistent with the State Telework Policy and the DMHC’s Telework Policy. All employees who telework are required to be California residents and maintain California residency in accordance with Government Code 14200.

Minimum Requirements

You will find the Minimum Requirements in the Class Specification.

• HEALTH PROGRAM SPECIALIST I

Additional Documents

• Job Application Package Checklist
• Duty Statement

Position Details

Job Code #:

JC-525007

Position #(s):

409-572-8338-004

Working Title:

Provider Networks Specialist

Classification:

HEALTH PROGRAM SPECIALIST I

$6,623.00 - $8,290.00

New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable.

# of Positions:

1

Work Location:

Sacramento County

Telework:

Hybrid

Job Type:

Permanent, Full Time

Department Information

The mission of the Department of Managed Health Care (DMHC) is to ensure health plan members have access to equitable, high-quality, timely, and affordable health care within a stable health care delivery system. The DMHC accomplishes its mission by ensuring the health care system works for members. The Department protects the health care rights of Californians by regulating health care service plans, assisting members through a member Help Center, educating members on their rights and responsibilities and preserving the financial stability of the managed health care system.

DMHC values diversity at all levels of the organization and is committed to fostering an environment in which employees from a variety of backgrounds, cultures, and personal experiences are welcomed and can thrive. DMHC believes the diversity of our employees and their unique ideas inspire innovative solutions to further our mission. Join DMHC and help us improve the lives of all Californians.

If you are interested in learning about the Department of Managed Health Care (DMHC) culture from the perspective of someone like yourself, contact our Someone Like Me program (please check your Spam or Junk folders for our email replies). Within five business days of your request to participate in the Someone Like Me program, you will be matched with a DMHC employee with a similar background to discuss the DMHC’s culture. This program is not part of, or in any way affiliated with the application or hiring process. Prospective employees must complete the application process on Cal Careers (e.g., submit your application within the specified timeframes on the job posting) to be considered for hire at the DMHC. None of the information you provide through the Someone Like Me program will be relayed to the Hiring Unit.

Department Website: http://www.dmhc.ca.gov

Special Requirements

• The position(s) require(s) a Background Investigation be cleared prior to being hired.

Any documents you submit for a job vacancy such as your state application, resume, cover letter, educational transcripts, etc. SHOULD NOT include ANY confidential information. Confidential information that should be excluded or removed from these documents include, but is not limited to, your Social Security Number (SSN), birthday, driver’s license number (unless required), basis of eligibility, examination results, LEAP status, marital status, and age. Confidential information on the first page of applications submitted electronically online, such as Easy ID number, SSN, examination related information, and driver’s license number will automatically be redacted upon submission.

Possession of Minimum Qualifications will be verified prior to interview and/or appointment. If you are using education to meet the minimum qualifications for this position, you must submit a copy of your high school transcripts or college/university transcript(s). Unofficial transcripts may be accepted during the application process; however, submission of official transcripts may be required prior to appointment.

Desirable Qualifications

• Experience working in the health care industry and/or experience working on health program related projects
• Experience with project management and providing leadership and assistance in developing and implementing new policies and procedures.
• Strong quantitative and qualitative data analysis skills
• Ability to plan, organize, and establish simultaneous workload priorities and work under pressure
• Exercise a high degree of initiative, independence, flexibility, and confidentiality
• Ability to work cooperatively and effectively with others
• Ability to professionally communicate both orally and in writing
• Ability to reason well and use good judgment
• Dependable, punctual, and excellent attendance
• Demonstrated experience using technical software, including, but not limited to: Word, Excel and Access

Benefits

Benefit information can be found on the CalHR website and the CalPERS website.

Contact Information

The Human Resources Contact is available to answer questions regarding the application process. The Hiring Unit Contact is available to answer questions regarding the position.

Department Website: http://www.dmhc.ca.gov

Human Resources Contact:

DMHC Recruitment

[phone]

[e-mail]

Hiring Unit Contact:

Susanna Williams

[phone]

[e-mail]

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 Office

[phone]

[e-mail]

California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device.

Statement of Qualifications Instructions

Statement of Qualifications (SOQ) Instructions: An SOQ is a narrative discussion of how a candidate's education, training, experience, and skills qualify them for the position. It will be used as a pre-interview screening tool.

Interested individuals MUST submit a SOQ along with their application. The SOQ serves as a documentation of each candidate's ability to present information clearly and concisely in writing. The completed SOQ should not be longer than one (1) typewritten page in length, single-spaced, Arial12 point font.

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.