Job Description

Job Description and Duties

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, apply today!

About this Role:

The role of the Health Program Audit Manager I (Specialist) (HPAM I) is to preside over informal level of reviews, fair hearings, other administrative hearings and appeals involving financial assessments and disputes between health programs administered by various State departments and contract providers of services. The HPAM I ensures the administrative appeals process is fair, efficient, and timely. The HPAM I conducts the most complicated administrative appeals, including, but not limited to, matters that arise from cost report audits, denials of Medi-Cal provider enrollment, refusals to readmit and involuntary transfers/discharges of skilled nursing residents, direct care service hours per patient day audits, Medi-Cal provider suspensions, and Women Infant and Children fair hearings. The HPAM I has the responsibility to develop, implement, and perform appeal procedures for new types of appeals. These matters involve sensitive and complex information, substantial amounts of funds, and interpretation of complex laws, regulations, and departmental policies. The incumbent is required to work with internal and external parties, which may include company executives, attorneys, county officials, consultants, auditors, accountants, and program administrators, in order to interpret their arguments into a logical framework for a decision. The HPAM I writes sound decisions that are grammatically correct and consistent with laws and regulations. The HPAM I reviews internal controls, organizational policies and procedures, and makes suggestions for improvement.

Have questions and/or need assistance? Contact Recruit@dhcs.ca.gov , we are here to help walk you through the state hiring process!

This position is subject to the Department's Conflict of Interest Code and filing a Statement of Economic Interests (Form 700) when assuming office, annually while in office, and upon leaving office.

The Staff Management Auditor eligible list may be used to fill this position. Candidates whose eligibility is based on results from the Staff Management Auditor exam must meet the minimum qualifications of both the Staff Management Auditor and Health Program Audit Manager I classifications.

You will find additional information about the job in the .

Working Conditions

Please see the Telework and Salary Information section below for telework, reporting location, and temporary statewide salary reduction details.

Special Requirements

Simple Application Steps

If you are interested in this position, complete the following simple steps:

1. Review the education and experience minimum qualifications (MQ’s) of the Health Program Audit Manager I and Staff Management Auditor . See the Minimum Requirements section above.
2. Complete the statement of qualifications and the state application by clicking “Apply Now” above. See below for detailed application instructions.
3. Submit your application package with all required documents, which include the statement of qualifications - see the "Required Application Package Documents" section below.
4. Once you have applied, take the Staff Management Auditor Examination.

Statement of Qualifications Requirement Section

Applicants must include a Statement of Qualifications (SOQ) for this recruitment. The SOQ is a narrative discussion, not a cover letter, prepared by the applicant describing how their skills, knowledge, abilities, education, training, and experience, qualify them for the position. The SOQ serves as documentation of the applicant’s ability to present information clearly and provide DHCS additional information about their experience and qualifications concisely in writing. The DHCS may not consider applicants who fail to provide an SOQ with their application. Resumes do not take the place of the SOQ.

The SOQ must be no more than two pages in length, single-spaced and using 12-point font. You must indicate your Full Name and Job Control Number at the top right corner.

Candidates who do not complete and submit an SOQ may not be considered for this position.

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:

• Good written and verbal communication skills
• Experience with analytical and critical thinking
• Ability to organize and prioritize work in order to complete assignments in a timely manner
• Ability to exercise objectivity and fairness
• Experience and knowledge with the application of Medicare reasonable cost principles
• Experience with conducting financial audits
• Ability to proactively problem solve
• Good legal researcher
• Good interpersonal skills

Benefits

DHCS is dedicated to creating an innovative workplace for its team members that is inclusive, diverse, and interactive! Here are a few of the ways we stay engaged with our team:

• Continuous and ongoing training
• Diversity, Equity, and Inclusion program activities
• Employee Assistance Program (EAP)

Additionally, as a team member of the State of California, you may be eligible for many benefits, such as:

• 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 .

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.

Telework and Salary Information

This position is currently eligible for telework up to three days per week and is required to report in person a minimum of two days per week. 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: 3831 N. Freeway Boulevard, Sacramento, CA 95834

Personal 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. Please reach out to the hiring unit contact listed on this job advertisement for details.

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 required and must be included.
• Statement of Qualifications -

  Refer to the Statement of Qualifications Requirement Section for instructions.

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