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SalaryThe Investigator conducts full and complete criminal/civil investigations into allegations of fraud perpetrated against the California Medical Assistance Program (Medi-Cal) and other programs under the review of the Department of Health Care Services. All Investigators, Department of Health Care Services (DHCS), are peace officers under California Penal Code, Section 830.3(h) which performs investigative duties comparable to other peace officers.
DHCS Audits & Investigations (A&I) Division utilizes a field based investigative model which requires investigative staff to leave directly and return to their residences or secured parking location for field assignments at the beginning and at the end of each work day; investigative staff are provided state law enforcement vehicles to perform their field duties, and although A&I maintains regional field offices, investigative staff spend a minimum of 90 percent of their assignments in the field, and only coming to their assigned office to accomplish those tasks which cannot be completed in the field.
- During the course of their employment, they are required to carry a firearm and be proficient in its use.
- Maintain a neat personal appearance and wear plain clothes while maintaining firearm concealed
- Ability to analyze situations accurately, draw valid conclusions, and take an immediate and effective course of action during stressful or adverse conditions
- Willingness to travel throughout the state of California based on business needs; gather and analyze facts and evidence; reason logically, draw valid conclusions, and make appropriate recommendations; recognize and respect diversity through words and actions; effectively investigate allegations of misconduct pursuant to departmental policy; treat all people with respect and in an unbiased and unprejudiced manner.
If you are interested in this position, it is critical to review the Classification Specifications to determine if you will meet the minimum qualifications (MQ’s). Please make note of Education and Experience requirements for the classification.
If you are meeting minimum qualifications with education, you must include a copy of your diploma/degree and/or unofficial/informal transcripts for verification. Official transcripts may be required upon appointment.
Please submit a Standard State Employment Application Form (STD 678). Applications will be screened and only the most qualified candidates will be interviewed. Failure to complete the STD. 678 in its entirety may result in disqualification.
Electronic applications are highly encouraged.
You will find additional information about the job in the Duty Statement.
Working Conditions
Below are the options Department of Health Care Services - Audits & Investigations offers incumbents:
- Regular or recurring telework may occur as part of the incumbents ongoing regular schedule per DHCS’s Telework Policy, in accordance with Government Code Sections 14200 – 14203 for employees residing in California.
- Telework stipends are currently available
- State issued vehicle and phone
- Flexible work schedules
- Training & Development opportunities
- Bilingual (B) Candidates will have an opportunity to receive bilingual pay of $100 a month for employees; contingent they meet CalHR requirements
- An opportunity to receive educational incentive pay ranging from $50-$125 a month for qualified employees.
Minimum Requirements
You will find the Minimum Requirements in the Class Specification.- INVESTIGATOR
Additional Documents
- Job Application Package Checklist
- Duty Statement
Position Details
Department Information
Department of Health Care Services (DHCS) is California’s health care safety net, helping millions of low-income and disabled Californians each and every day. The mission of DHCS is to provide Californians with access to affordable, integrated, high-quality health care, including medical, dental, mental health, substance use treatment services and long-term care. Our vision is to preserve and improve the overall health and well-being of all Californians.
The purpose of DHCS is to provide the most vulnerable residents access to affordable, integrated, high-quality health care.
DHCS is a dynamic department with ambitious goals and talented, committed employees. We work hard every day to fulfill our vital responsibility to support the delivery of quality health care to Californians. DHCS is committed to addressing disparities within our organization and in our communities through efforts toward greater diversity, equity, and inclusion. This is accomplished, in part, by a commitment toward employing a diverse workforce, which reflects the many communities we serve, and by promoting and enforcing equal employment opportunity.
Audits and Investigations (A&I) is the designated Program Integrity Unit for California’s Medicaid program – Medi-Cal. A&I’s mission is to protect and enhance the integrity of the health programs administered by DHCS. To carry this out, A&I performs financial and compliance audits, including post-service post-payment utilization reviews, of Medi-Cal providers; performs compliance and med ical audits of medical, dental and behavioral health managed care plans; identifies and investigates Medi-Cal provider and beneficiary fraud, waste, and abuse, emphasizing fraud prevention; ensures accountability of state and federal health care funding by recovering identified overpayments; performs onsite reviews as part of the Medi-Cal provider enrollment process; provides technical assistance (financial and medical) for the development and enhancement of DHCS health programs and related policy; and provides technical assistance and audited data to support health care financing initiatives and objectives such as provider rate setting.
Investigations Division (ID) conducts administrative and criminal investigations pursuant to the statewide Medi-Cal and other DHCS programs’ fraud, waste, and abuse investigative program. Specific activities include fraud data analytics, Medi-Cal fraud Hotline and complaint intake, investigative audits, provider fraud investigations, and beneficiary fraud investigations.
A&I is seeking a candidate to join as an Investigator. Please direct all questions to the hiring unit contact listed in this job posting.
Special Requirements
- The position(s) require(s) a Drug Screening be passed prior to being hired.
- The position(s) require(s) a Background Investigation be cleared prior to being hired.
- The position(s) require(s) Medical Clearance prior to being hired.
- The position(s) require(s) Psychological Evaluation clearance prior to being hired.
Individuals who claim list eligibility must have reachable placement on the appropriate certification list for a classification they apply to.
- Exam Link: https://www.calcareers.ca.gov/CalHRPublic/Exams/Bulletin.aspx?examCD=1PB02
Application Instructions
Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.
Final Filing Date: 3/15/2024Who May Apply
Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process. Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).
How To Apply
Address for Mailing Application Packages
You may submit your application and any applicable or required documents to:
Address for Drop-Off Application Packages
You may drop off your application and any applicable or required documents at:
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 www.CalCareers.ca.gov. 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.
Benefits
The state offers comprehensive benefits for its employees, who provide essential and exceptional service to millions of Californians every day.
- Health, Vision and Dental
- Retirement
- Savings Plan
- Group Legal Service Insurance
- Vacation/Annual Leave Accrual
- Paid Holidays
- Employee Assistance Program
Benefit information can be found on the CalHR and CalPERs websites.
In addition, DHCS – Audits & Investigations offer:
- Training opportunities to support role
- Upward Mobility
Contact Information
The Hiring Unit Contact is available to answer questions regarding the position or application process.
Hiring Unit Contact:
Ronald Lizardo
(323) 707-7962
ronald.lizardo@dhcs.ca.gov
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 Officer
(916) 440-7370
civilrights@dhcs.ca.gov
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.
Additional Information
Using the online application system as specified in the announcement is the preferred method of applying for civil service job opportunities; however, applicants may instead apply by way of U.S. mail, parcel delivery or courier service, or in person, as set forth in this announcement.
Paper applications must include a signature. Dates printed on envelopes by mobile barcodes or equivalent mobile print technology are not acceptable proof of the date the application and any other required documents or materials were filed.
A completed state application (STD. 678) and any documents list under “Required Application Documents” must be submitted with your application package. Applicants who are relying on additional documentation (e.g., transcripts, copy of degrees, certifications, licenses, etc.) in order to prove that they meet the minimum qualifications listed in the Classification Specification (located on the right under “Additional Documentation) must submit those documents with their application package. Failure to submit these documents may result in your application being disqualified. Applications must include a description of the duties performed for each position held; reference to a resume in place of a description of the duties performed will not be accepted.
Applicants must state their basis of eligibility (List Eligibility, Lateral Transfer, Reinstatement, T&D, or Surplus/SROA), and the Job Control (JC) number and/or position number in the “Examination(s) or Job Title(s), For Which You Are Applying” section on the STD. 678. Surplus/SROA candidates should submit a copy of their letter with their application. Please remove any confidential information (i.e. social security number, date of birth, etc.) as well as any information regarding your LEAP eligibility and/or exam scores from your documents prior to submission.
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.
