Nurse Specialist Program Evaluation

Nurse Specialist Program Evaluation

Psych-ZSFG-Adult-AHP

Full Time

86408BR

Job Summary

This position is based in Sacramento. Travel is required; 2 to 3 days a month to sites in California.

The Medi-Cal Waiver Program (MCWP) will be sunsetting at CDPH as early as 2028, meaning the UCSF Nurse Specialist - Program Evaluation position will end at the same time. California is transitioning to an integrated managed long-term services and supports (MLTSS) system to improve the efficiency of program administration, operations, and service delivery systems allowing Californians to more effectively find and obtain high-quality person-centered care and enhancing the state's ability to predict Medi-Cal costs and measure member outcomes. The Department of Health Care Services (DHCS) released a gap analysis report in February 2025 and is now using its findings to collaborate with sister state departments and key stakeholders to develop a multi-year roadmap to integrate select Home and Community Based Services (HCBS) services into managed care. DHCS plans to draft and submit a concept paper for HCBS managed care integration to the Centers of Medicare & Medicaid Services (CMS) in early 2026 before finalizing the multi-year roadmap, with integration occurring no earlier than 2028.

The California Department of Public Health (CDPH), Office of AIDS (OA), Quality Improvement Health Care Specialist 4, provides highly specialized nurse consultation, technical assistance (TA), training and education to CDPH / OA staff and Medi-Cal Waiver Program (MCWP) Agency personnel. Uses practical nursing knowledge, professional expertise, and sound clinical judgment to serve as the MCWP Nurse performing all MCWP clinical functions to ensure that MCWP participants receive high quality and appropriate care, that MCWP Agencies meet state and federal clinical compliance requirements, and that CDPH / OA meets Centers for Medicare and Medicaid Services (CMS) Home and Community Based Services (HCBS) 1915(C) MCWP Waiver requirements. Evaluates and certifies Nursing Facility Level of Care (NF LOC) for MCWP participants, conducts the clinical portion of Program Compliance Reviews (PCRs) through on-site monitoring and desk audits for MCWP Agencies, and documents progress on meeting CMS HCBS performance measures. Creates and facilitates clinical internal and external trainings, and writes the clinical sections of MCWP plans, reports, surveys, drills, and requests for information. Analyzes medical data and documentation, identifies trends and barriers, develops and presents recommendations to CDPH / OA management.

Must have the ability to work efficiently in a fast-paced environment, manage multiple competing tasks, be flexible with changing priorities, and monitor time efficiently to complete all deliverables. Must be able to work as an independent subject matter expert on clinical nursing tasks and collaboratively on a team with analysts, specialists, managers, and state department partners. Must be open-minded when dealing with the public, be able to communicate with difficult people, and handle public inquiries received by the HIV Care Branch. Requires outstanding verbal and written communication skills with the ability to translate complex clinical regulatory requirements and convey information to multiple audiences in an accurate, concise, and effective manner. Must maintain knowledge of HIV, case management practices, healthcare systems, Medi-Cal, and Home and Community Based Services (HCBS) waiver requirements. Required to research and communicate to their direct supervisor any new significant clinical developments, changes in nurse case management practices or requirements, and elevate clinical concerns promptly. Must have advanced knowledge and proficiency with Microsoft Office Suite, including Outlook, Word, Teams, and PowerPoint. Heavy travel required. Performs other duties as assigned.

The final salary and offer components are subject to additional approvals based on UC policy.

Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement.

The salary range for this position is $140,800 - 150,000 (Annual Rate).

To learn more about the benefits of working at UCSF, including total compensation, please visit : https : / / ucnet.universityofcalifornia.edu / compensation-and-benefits / index.html

Department Description

The Alliance Health Project (AHP) is an LGBTQ+ and HIV-focused division of the Department of Psychiatry. We provide psychotherapy, substance use counseling, case management, support groups, psychiatry, sexual health services, clinical training, and provider education. Our multidisciplinary team is client-centered, collaborative, and committed to meeting people where they are in their lives and care journeys. For over 35 years, we've evolved to meet the changing needs of our communities. Our approach is rooted in cultural humility, equity, and respect for the diverse experiences of those we serve.

Required Qualifications

• Bachelor of Science in Nursing (BSN) and two years of experience as an RN. Five years related experience or equivalent experience / training
• In depth knowledge of medical case management principles and standards of care
• In depth knowledge of HIV and AIDS disease process and clinical standards of care for People Living with HIV
• Ability to analyze clinical data and assess level of care needs, medical case management as well as other support services
• In depth knowledge of Quality Improvement standards, clinical chart review, abstraction, and regulatory requirements
• Detail oriented, with proven ability to effectively manage time, see projects through to completion, organize competing priorities and effectively address complex, urgent issues as they arise
• Strong critical thinking and problem-solving skills to manage multiple levels of information and responsibilities, assess complex problems, develop and implement timely and effective solutions. Advanced organizational and project management skills, with the ability to lead a team, prioritize tasks, and see projects through from inception to completion on schedule
• Strong interpersonal skills for collaborating effectively with a broad range of clinical and technical staff. Advanced skills to influence and persuade staff, management, and clinicians at all levels and across departments
• Ability to apply increasing independence in clinical judgment, management concepts and provide counseling. Advanced critical thinking and problem-solving skills to manage multiple levels of highly complex information and responsibilities, to quickly assess problems, and to develop and implement timely and effective solutions
• Ability to work in a multi-disciplinary, collaborative work environment. Advanced interpersonal skills for collaborating effectively with all levels of clinical and technical staff and representatives of external regulatory agencies
• Able to follow written and verbal directions accurately
• Advanced skills required to effectively convey complex clinical and technical information both verbally and in writing, prepare and complete quality reports and documentation
• Advanced knowledge of various administrative and business software packages, and of specialized applications for quality data management. Strong knowledge of various administrative and business software packages including Word, Excel, PowerPoint, etc., ability to utilize specialized applications for quality data management

Preferred Qualifications

License / Certification

About UCSF

The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences. We bring together the world's leading experts in nearly every area of health. We are home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging and stem cells.

Pride Values

UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.

In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu

Join us to find a rewarding career contributing to improving healthcare worldwide.

Equal Employment Opportunity

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.

Organization

Campus

Job Code and Payroll Title

006525 QLTY IMPV HC SPEC 4

Job Category

Nursing - Adult Services, Other Nursing

Bargaining Unit

99 - Policy-Covered (No Bargaining Unit)

Employee Class

Career

Percentage

100%

Location

Sacramento, CA

Work Style

Fully On-Site

Shift

Days

Shift Length

8 Hours

Additional Shift Details

Monday - Friday, 8AM-5PM; 1616 Capitol Avenue Sacramento, CA