Health Care Financing Deputy Director
The Department of Health Care Services (DHCS) has an immediate opening for the Deputy Director of Health Care Financing. This is one of four Deputy Director positions in (DHCS) that oversees DHCS’ health care programs. Under the administrative direction of the DHCS Director and the Chief Deputy Director, for Health Care Programs, the Deputy Directors serve as integral components in the formulation of policy to achieve the mission of the Department. To accomplish this mission, DHCS finances and administers a number of individual health care service delivery programs.
• Provide health care services to low-income persons and families who meet defined eligibility requirements;
• Emphasize prevention-oriented health care programs that promote human health and well-being;
• Ensure access to comprehensive health services using public and private resources;
• Ensure appropriate and effective expenditure of public resources to serve those with the greatest health care needs;
In addition to serving as a member of the Directorate, the Deputy Director, Health Care Financing will be responsible for the development, promotion, and implementation of health care delivery systems to more than 12 million beneficiaries in California’s Medi-Cal program and provide direct leadership over three divisions: Capitated Rates Development Division, Fee For Service Rates Development Division, and Safety Net Financing Division and work collaboratively with the other Deputy Directors in administering the Medi-Cal total budget of over $90 billion annually.
Specifically the incumbent:
• Directs and coordinates health care financing policy to ensure a sustainable delivery system that is capable of providing high quality health care to Medi-Cal beneficiaries.
The incumbent is responsible for directly overseeing the following:
Capitated Rates Development Division: This division is responsible for setting health care financing policy for all of the Medi-Cal managed care plans and other capitated contracting providers. This includes developing capitated rate methodologies and setting health plan rates. These plans and providers are responsible for care to more than 9 million Medi-Cal beneficiaries.
Safety Net Financing Division: This division is responsible for hospital financing policy, include DSH and 1115 Waiver payments, a wide variety of supplemental payment programs including clinics, nursing homes, rural hospitals, and school, and county administrative claiming of costs incurred in the Medi-Cal program. These programs are responsible for billions of dollars in reimbursement to safety net providers.
Fee for Service Rate Development Division: This division is responsible for establishing Medi-Cal reimbursement methodology and reimbursement rates for Medi-Cal fee-for-service outpatient services. In addition, they are responsible for conducting the annual studies to calculate and develop Medi-Cal rates for long-term care providers.
• Establishes and implements policies and procedures for the effective operation of the Medi-Cal program.
• Advises and consults with the Director, Chief Deputy Directors, and other Deputy Directors concerning issues of significant policy impact.
• Represent DHCS in contact with public and private organizations, and local, state, and federal government officials in Medi-Cal program matters.
• Directs and evaluates the planning activities necessary to improve operations among the divisions within Health Care Financing.