This position is pending all appropriate approvals
If you are interested in this position, please submit your application to the address listed and reference your list or transfer eligibility in the 'Explanations' section of your State Application. Please include a copy of your exam results if applicable.
Duty Statement - Associate Governmental Program Analyst
Job Summary - The Associate Governmental Program Analyst (AGPA) position in the Medi-Cal Eligibility Branch – Program Review Section generally works independently at the full journey person level. The AGPA is responsible for collecting, verifying, and analyzing data on Medi-Cal cases to assess the accuracy of Medi-Cal eligibility determinations and the Share of Cost Computations. The AGPA must have the following ability and experience: Ability and experience to work independently and use good judgement. Ability and experience to work with regulations and policies. Ability and experience to work with different types of staff. Ability and experience to analyze complex situations, identify problems and develop solutions. Ability and experience to develop and implement work plans and review schedules. Ability to use a personal computer, software packages and county automated programs. Ability and experience to generate reports and make oral presentations.
Percent of Time - Essential Functions
65% - The AGPA has the following major responsibilities utilizing Medi-Cal Eligibility Quality Control (MEQC) data: Analyzes MEQC data for potential error trends. Recommends possible corrective action on error trends to state and county management. Writes and presents reports derived from MEQC review data. Works proactively with the counties on an ongoing basis on potential problem areas identified through MEQC review. Consults regularly with counties, which have MEQC error rates above tolerance levels, to discuss the problem(s), causes and possible corrective action plans. Performs corrective action follow-up reviews to assess county efforts to correct MEQC error findings. Develops and designs focused review concepts from MEQC data for management. Works cooperatively with county Medi-Cal program staff on focused review concepts generated from MEQC data and from county concerns. Assesses county compliance with state Medi-Cal policy through the monthly MEQC case reviews, focused reviews and special studies. Determines the efficacy of new state Medi-Cal policies or programs as reflected in the ongoing MEQC case reviews. The AGPA conducts Medi-Cal Eligibility Quality Control (MEQC) reviews of randomly selected Medi-Cal cases. As appropriate, conducts home visits and personal interviews with beneficiaries, responsible relatives, third parties (e.g.,employers, banks, insurance companies and staff from other government entities) to verify and supplement the information contained in the case record. Compares and analyzes information obtained through case record review and field investigation to determine the accuracy of the agency’s eligibility and share-of-cost (SOC) determination. Prepares written correspondence to agencies outlining identified eligibility and SOC discrepancies and related issues. The AGPA, through the use of the section’s automated Q5 program, Microsoft Word, Outlook and Excel, provides accurate data in support of statistical reporting formats (e.g., error trends, problem areas, and misapplication of policy). The AGPA provides one-on-one consultation to specific agencies on new eligibility policy issues, changes and identified areas of concern.
25% - The AGPA performs the following duties while participating in assigned Focused Reviews and Special Projects: Assesses county performance through follow-up focused reviews. Analyzes review findings of focused reviews and special projects and documents and presents logical conclusions that are consistent with the data. Presents review findings to DHS management and county Medi-Cal program staff in a written report and in oral presentations. Develops and designs review methodology and templates for focused reviews and special assignments. Trains Program Review Section staff in the implementation of new review methodology or templates. Evaluates county best practices for possible adoption by other counties. Consults with county Medi-Cal program staff on areas of common concern. Defines issues, develops and conducts focused reviews, which may address a county’s eligibility determination performance. Participates in special Department of Health Services evaluation projects in conjunction with state and federal authorities. As team leader, the AGPA acts as the liaison between the review team and the county agency to resolve complex onsite review issues related to policy and procedure interpretations and review activities and to make arrange specific details for the onsite review (i.e., onsite dates, sample size, and review activities). The team leader also conducts entrance and exit conferences, and makes presentations of findings to county, state and federal program staff, and to Program Review Section staff and management. The team leader meets with county, state and federal staff to present and implement MEQC review findings and formulates and monitors appropriate corrective action strategies. Develops, conducts, documents and provides for implementation of specific management efficiency and policy studies. The AGPA participates in the evaluation of county automated eligibility systems, Quality Improvement Circles, All Staff meetings, Central Control Unit activities. Participates in administrative support functions, staff development training, regional staff meetings, and required forms completion. The AGPA must also have the knowledge of various Department of Health Services automated data information systems (i.e. MEDS, IEVS, SAVE).
5% - Conducts Negative Case Action Reviews (NCR) of randomly selected Medi-Cal cases to determine the accuracy of the agency’s denial and termination actions. As the AGPA, communicates with county administrative staff, arranges specific details for the onsite review (i.e., date, sample size, and review activities); communicates findings on a flow basis to agency management; analyzes review findings; prepares written and oral reports and presentations; and conducts exit conferences.
Percent of Time - Marginal Functions
5% - Conducts administrative support duties and other assignments in support of regional and statewide MEQC functions as assigned by the region chief.
Associate Governmental Program Analyst
805 - 323 - 5393 - 709
S Spring Street, Los Angeles
Final Filing Date:
UMD / Recruit Unit 323 / Southern Unit P.O. Box 997419, MS 4506 Sacramento, CA 95899-7419
Katie Kellinger 916-319-9254
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