Job Description

Job Description and Duties

The Help Center assists consumers with health care issues and through its regulatory authority ensures that managed health care enrollees receive the medical care and services to which they are entitled.

Under the direction of the Independent Medical Review and Complaint Branch Chief, the Staff Services Manager II (SSM II) is responsible for directing and managing program activities within the Help Center’s Independent Medical Review Section (IMRS) pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (KKA), Title 28 of the California Code of Regulations (CCR). The incumbent is responsible for ensuring the short and long-term objectives meet the Department’s mission, including managing resources to achieve program objectives in the most effective and efficient manner and monitors conformity with the Department’s policies and procedures. The SSM II handles the most highly sensitive complaints, all phases of program operations, policy decisions, and has direct oversight of the IMRS activities to ensure compliance with the KKA.

This position is eligible for a hybrid telework schedule under Government Code 14200. Under the Department of Managed Health Care’s (DMHC) current hybrid telework policy, employees may be required to report in-person to the office two times per week and will be required to utilize a shared or “hotel” workspace. Employees may also be required to report in person more frequently as determined by management, which may include working at a DMHC designated headquarters and/or offsite events or locations. Employees must work from a location within California while employed at the DMHC.

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You will find additional information about the job in the .

Working Conditions

The DMHC utilizes a hybrid telework model to provide all employees with an avenue to telework while ensuring business and operational needs are met.

Remote-Centered employees are expected to maintain a safe and distraction free work environment at the approved alternate work location. Remote-Centered employees agree to adhere to the state telework policy, the DMHC’s telework policy, and conditions cited in the Telework Agreement (STD 200).

Office-Centered employees are expected to maintain a dedicated workstation at a DMHC official worksite. Office-Centered employees are expected to work in a climate-controlled office or cubicle under artificial lighting.

Special Requirements

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

All applicants not currently employed by the DMHC will be subject to a pre-employment background investigation. The investigation will consist of fingerprinting and an inquiry to the California Department of Justice to disclose criminal records.

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

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:

• The ideal candidate should be familiar with DMHC mission, goals, organizational structure and major work programs.
• The ideal candidate must also have a demonstrated positive attitude and a commitment to conduct business in a professional manner in dealing with the public.
• Provide quality customer service to all customers, and deal tactfully, professionally and confidentially with all internal and external customers.
• Have knowledge of health plans and medical terminology; administrative functions; policy analysis and formulation; and principles of effective training.
• Experience working in a high volume, fast paced environment.
• Have the ability to evaluate situations accurately and take effective action; communicate effectively; solve difficult personnel issues; conduct management analysis; program evaluation and planning; research, understand, interpret; and apply applicable laws, regulations and office policies and procedures.

Benefits

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

Additional Application Instructions

To be considered for this vacancy, please complete all applicable fields on the application form, including a list or description of previous/current occupational experience in the duties performed section.

Do NOT include your social security number on any submitted documents. If submitting your application via postal mail or in person, please notate RPA: 23-355 and Job Control: JC- 440462 on your application.

All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to clearly demonstrate how you meet the Minimum Qualifications for the position on your State Application (STD Form 678). The application should also clearly demonstrate the candidate’s ability to meet the Desirable Qualifications identified in this job advertisement. The Classification Specification for the Staff Services Manager II is located at the top of this Job Announcement Posting under Minimum Requirements.

Foreign Degrees or Transcripts – Applicants with foreign degrees or transcripts who wish to apply that coursework toward meeting the minimum qualifications of the classification must provide a transcript evaluation that indicates the number of units to which his/her foreign coursework is equivalent. DMHC accepts foreign transcript evaluations that are completed by one of the agencies approved by the California Commission on Teacher Credentialing .

PLEASE NOTE: If you are mailing your application, it must be postmarked by the final filing date. Hand delivered applications must be submitted no later than 5:00 p.m. on the final filing date. Applications slipped under the door at the Human Resources Office will be time stamped the following business day.

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.
• Statement of Qualifications -

  The Statement of Qualifications (SOQ) is a MANDATORY requirement to apply for this position. The SOQ will answer specific questions and provide insight to the hiring manager regarding the candidate’s education, training, experience, and skills to meet the minimum and desirable qualifications for the position.

  Please see section labeled Statement of Qualifications Instructions for further direction.

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