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NURSE EVALUATOR II, HEALTH SERVICES

Department of Managed Health Care -
Sacramento County, CA

Job Details

Full-time
$7,430 - $9,757 a month

Qualifications

RN License

Full Job Description

Department of Managed Health Care

JC-519401

Nurse Evaluator II
NURSE EVALUATOR II, HEALTH SERVICES

$7,430.00 - $9,757.00 per Month
New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable.

Final Filing Date: 6/12/2026

Job Description and Duties

The DMHC Help Center educates members about their health care rights and resolves complaints against health plans to ensure a stable and accessible health care delivery system.

Under the direction of the Nurse Evaluator IV, the incumbent is responsible for providing clinical and professional support for all offices of the Help Center (i.e., Contact Center Branch, Independent Medical Review Branch, Standard Complaint Branch, and Legal Affairs Branch). The incumbent is responsible for providing support to staff on issues related to health care member complaints filed with the DMHC pursuant to the Knox-Keene Health Care Service Plan Act of 1975, Title 28 of the California Code of Regulations, and health plan member contracts, i.e., Evidence of Coverage. The incumbent is responsible for reviewing, researching, and/or gathering clinical information to determine or affirm the appropriate handling of a health plan member complaint by contacting the member, their representatives, and/or health plans. They may also contact other public departments or agencies for information related to the complaint. In addition, the incumbent implements and ensures compliance with the Department’s Strategic Business Plan goals.

Please let us know how you heard about this position by taking a brief survey: DMHC Recruitment Survey

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.

Working Conditions

The DMHC has locations in Downtown Sacramento and Rancho Cordova. Both locations are located close to light-rail with various amenities. The incumbent will work in a climate-controlled cubicle and/or office environment with artificial lighting.

This position may be eligible for hybrid telework. The telework schedule is permitted at the operational needs of the Department and is subject to change, consistent with the State Telework Policy and the DMHC’s Telework Policy. All employees who telework are required to be California residents and maintain California residency in accordance with Government Code 14200.

Position Details

Job Code #:

JC-519401

Position #(s):

409-161-8144-006

Working Title:

Nurse Evaluator II

Classification:

NURSE EVALUATOR II, HEALTH SERVICES

$7,430.00 - $9,757.00

New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable.

# of Positions:

Work Location:

Sacramento County

Telework:

Hybrid

Job Type:

Permanent, Full Time

Department Information

The mission of the Department of Managed Health Care (DMHC) is to is to ensure health plan members have access to equitable, high-quality, timely, and affordable health care within a stable health care delivery system. The DMHC accomplishes its mission by ensuring the health care system works for consumers. The Department protects the health care rights of 30.2 million Californians by regulating health care service plans, assisting consumers through a consumer Help Center, educating consumers on their rights and responsibilities and preserving the financial stability of the managed health care system.

DMHC values diversity at all levels of the organization and is committed to fostering an environment in which employees from a variety of backgrounds, cultures, and personal experiences are welcomed and can thrive. DMHC believes the diversity of our employees and their unique ideas inspire innovative solutions to further our mission. Join DMHC and help us improve the lives of all Californians.

If you are interested in learning about the Department of Managed Health Care (DMHC) culture from the perspective of someone like yourself, contact our Someone Like Me program (please check your Spam or Junk folders for our email replies). Within five business days of your request to participate in the Someone Like Me program, you will be matched with a DMHC employee with a similar background to discuss the DMHC’s culture. This program is not part of, or in any way affiliated with the application or hiring process. Prospective employees must complete the application process on Cal Careers (e.g., submit your application within the specified timeframes on the job posting) to be considered for hire at the DMHC. None of the information you provide through the Someone Like Me program will be relayed to the Hiring Unit.

Department Website: http://www.dmhc.ca.gov

Special Requirements

The position(s) require(s) a Background Investigation be cleared prior to being hired.
The position(s) require(s) a(n) Valid RN License to Practice in California License. You will be required to provide a copy of your license prior to being hired.

Licensure Requirements: Possession of a valid license to practice as a professional registered nurse in California.

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.

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: 6/12/2026

Who May Apply

Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list or LEAP eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates 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

Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at www.CalCareers.ca.gov. When submitting your application in hard copy, a completed copy of the Application Package listing must be included. If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below:

Address for Mailing Application Packages

You may submit your application and any applicable or required documents to:

Department of Managed Health Care

DMHC Recruitment

Attn: Human Resources Office

980 9th Street, Suite 500

Sacramento, CA 95814

Address for Drop-Off Application Packages

You may drop off your application and any applicable or required documents at:

Department of Managed Health Care

DMHC Recruitment

Human Resources Office

980 9th Street, Suite 500

Sacramento, CA 95814

08:00 AM - 05:00 PM

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.
Other - A Cover Letter is Required

Applicants requiring reasonable accommodations for the hiring interview process must request the necessary accommodations if scheduled for a hiring interview. The request should be made at the time of contact to schedule the interview. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this job posting.

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:

Should be familiar with DMHC mission, goals, organizational structure and major work programs.
Must have a demonstrated positive attitude and a commitment to conduct business tactfully, professionally and confidentially with all internal and external customers and contacts.
Ability and experience in providing quality customer service

Experience coordinating health care services
Experience reviewing, analyzing, and resolving consumer complaints
Experience health care service plan work with grievances and appeals
Experience in case management, or utilization management
Experience in acute inpatient hospital case management
Experience referencing, comprehending and administering law (statutes) and/or regulations

Benefits

Contact Information

The Human Resources Contact is available to answer questions regarding the application process. The Hiring Unit Contact is available to answer questions regarding the position.

Department Website: http://www.dmhc.ca.gov

Human Resources Contact:
Recruitment
(916) 322-8437
[email protected]

Hiring Unit Contact:
Weda Thao
(916) 255-3894
[email protected]

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 Office
(916) 738-3394
[email protected]

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 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: 25-237 and Job Control: JC-519401 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 Nurse Evaluator II, Health Services, 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 stamped the following business day.

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.

Application Methods:

Electronic (Using your CalCareer Account)

By Mail

Drop-off

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