Medical Consultant I
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Apply to Medical Consultant I at Department of Health Care ServicesJob details
- Location
- United States or California or West Sacramento or Los Angeles or Rancho Cucamonga or San Diego or Sacramento
- Work type
- Hybrid
- Compensation
- $160,464 - $237,480/yr
- Posted
- 4 days ago
- Apply on
- calcareers.ca.gov
About this role
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:
Under direction of the Medical Consultant II (Supervisor), the Medical Consultant (MC) I reviews and acts on Treatment Authorization Requests (TARs) and medical records received from providers for services to beneficiaries of the California Medical Assistance Program (Medi-Cal). The MC I provides consultation to the field office and headquarters nursing staff when adjudication decisions of TARs require denial or modification, and to nursing staff conducting post-claims oversight case reviews at assigned hospitals to ensure hospital compliance with Medi-Cal policy. The incumbent may be asked to review Appeals, Disputes and Litigation and may be required to represent the Department at Fair Hearings, Appeal Meetings, and Administrative Hearings. The incumbent may be asked to appear before peer groups, other provider groups, and community organizations to advise them on the medical aspects of the Program. Additionally, the MC I may be required to work on special projects involving medical chart reviews and assist in the Clinical Assurance Division’s (CAD’s) quality assurance efforts.
Travel statewide, including overnight, of up to 5% of the time, by airplane, train, automobile, and other transportation methods to attend Medical Consultant trainings and meetings may be required. Travel related duties may take up to a week at a time and several weeks per month and are dependent upon workload and operational need.
This is a re-advertisement of JC 506173. If you previously applied under JC 506173, you would need to re-apply under this new Job Control, JC 531066 in order to be considered.
New to state candidates will be hired into the minimum salary of the classification or minimum of the alternate salary range when applicable. Placement to alternate range may be based on education or experience identified in your state application.
This position is designated under the Conflict of Interest Code. The position is responsible for making or participating in the making of governmental decisions that may potentially have a material effect on personal financial interests. The appointee is required to complete Form 700 within 30 days of appointment and once per year. Failure to comply with the Conflict of Interest Code requirements may void the appointment.
This advertisement is posted as until filled. Applications will be reviewed monthly. The cutoff dates will be: September 23, 2026, October 7, 2026, October 21, 2026, November 4, 2026, November 18, 2026, December 2, 2026, December 16, 2026, December 30, 2026, January 13, 2027, January 27, 2027, February 10, 2027, and February 24, 2027.
You will find additional information about the job in the Duty Statement.
Working Conditions
Please see the Telework and Salary Information section below for telework, reporting location, and temporary statewide salary reduction details.
Minimum Requirements
You will find the Minimum Requirements in the Class Specification.Additional Documents
Position Details
Department Information
DHCS’ purpose is to provide equitable access to quality health care leading to a healthy California for all.
DHCS is a dynamic organization 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 that reflects the many communities we serve, and by promoting and enforcing equal employment opportunity.
Take a look at some of DHCS' recent projects and happenings that our Department has accomplished in the DHCS Newsroom.
Special Requirements
If you are interested in this position, complete the following simple steps:
- Review the education and experience minimum qualifications (MQ’s) of the Medical Consultant I Minimum Qualifications. See the Minimum Requirements section above.
- Submit your application package with all required documents, see the "Required Application Package Documents" section below.
- Once you have applied, take the Medical Consultant I CalCareers Examination.
Education: 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.
Application Instructions
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: Until FilledWho 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 optional. It may be included, but is not required.
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
DHCS 2023-2027 Strategic Plan 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.
Contact Information
The Hiring Unit Contact is available to answer questions regarding the position or application process.
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
[email protected]
Telework and Salary Information
Telework: This position is currently eligible for telework. 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 may be located in West Sacramento, Los Angeles, Rancho Cucamonga, and San Diego.
For a list of possible DHCS office assignment locations, please reference the reporting location document attached to the duty statement on this job advertisement.
Personal Leave Program (PLP) 2025 Agreement
Salary: 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.
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.
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.
All information on the Employment Application (STD 678) must be completed. Applicants should include all employment history on the Employment Application (STD 678), including detailed job descriptions, hours worked per week, and start/end dates (MM/DD/YYYY). Resumes or other documents may not be substituted for the Employment Application (STD 678).
If applying electronically, please note that CalCareers no longer allows applicants to withdraw their applications. If you need assistance to withdraw your application, please contact the Recruitment Section at [email protected]. For all other questions regarding your CalCareer account, please contact CalHR’s CalCareers Unit at (866) 844-8671 or [email protected].
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.