Refugee Medical Assistance Analyst

Overview

About this Role
Job Summary

This position supports the California Department of Public Health’s (CDPH) mission and strategic plan by independently performing varied and complex analytical, administrative, and fiscal work that advances the operations of the Office of Refugee Health (ORH).

The Analyst II leads assignments that advance program objectives for Refugee Medical Assistance (RMA), including monitoring and evaluating beneficiary eligibility data, analyzing medical claims for federal reimbursement, processing invoices and tracking expenditures, preparing and tracking contracts, and drafting program correspondence with grantees.

The incumbent reviews determination and redeterminations processes to ensure Refugee Medical Assistance (RMA) policies and CDPH procedures align with Office of Refugee Resettlement (ORR) requirements; identifies gaps; and initiates and implements corrective actions to maintain compliance. Coordinates work with Department of Health Care Services (DHCS) staff and serve as a consultative resource to partners on RMA policy and reporting.

The incumbent works under the direction of the Research Scientist Supervisor I, Chief of the Office of Refugee Health (ORH).

Key Responsibilities
Program Administration (40%) Leads a wide variety of administrative and analytical assignments. Coordinates with Department of Health Care Services (DHCS) staff and oversees and evaluates the Refugee Medical Assistance (RMA) program, including beneficiary eligibility, medical claims, and other required documentation. Ensures adherence to the Office of Refugee Resettlement (ORR) policies and federal RMA regulations by developing, updating, and maintaining internal procedures and compliance checklists. Prepares program correspondence to grantees, including award letters, reporting requirements, monitoring scheduling, and other related correspondence for the Refugee Health Promotion Program (RHPP). Responsibilities include managing filesystems and tracking invoices, reports, and other required documents within specified timeframes using Excel and SharePoint registers. Monitors administrative email boxes, categorizes tasks, and responds to or routes inquiries to appropriate staff. Prepares written and verbal responses to grantees and federal/state partners regarding budget revisions, concepts, and proposals, and supports development of federal reports. Initiates and documents corrective actions to address identified process issues and tracks outcomes to closure.
Fiscal and Contract Management (40%) Establishes and maintains program expenditure controls by tracking and monitoring local assistance expenditure logs; reviewing invoices, medical claims expenses, and supporting documentation for consistency and allowability; and preparing and maintaining grant expenditures spreadsheets and other program expenditure tracking tools (e.g., Excel/SharePoint registers). Prepares, reviews, and evaluates fiscal analyses for local assistance contract activities; develops expenditure tracking, budget planning, and projections; and reconciles outstanding encumbrances. Processes and tracks invoices and encumbrances, collaborates with accounting, program support staff, and vendors to resolve errors and discrepancies and document corrective actions. Ensures all expenses are allowable and adhere to state and federal guidance and funding conditions. Prepares, maintains, monitors, and submits program deliverables, and coordinates with CDPH Accounting, Contracts Management, Program Support and Budget staff, as needed. Collaborate with funded stakeholders to ensure accurate and timely receipt of invoices and reporting requirements and to verify fiscal and reporting compliance. Conducts on-site and off-site reviews of program and financial records to validate compliance. Assist with contract preparation and tracks the progress of new contracts and amendments; Consults with the Contracts Management Section and vendors during the contract process to ensure timely approval and execution.
Data Management (15%) Manages the receipt and tracking of grantee reports for state and federal reporting requirements and analyzes medical claims and eligibility data. Provides technical guidance and support regarding ORR eligibility, RMA policy, and claims submission procedures. Ensures that analyses comply with established procedures and eligibility standards; supports continuous improvement by documenting findings and recommending process enhancements; maintains data repositories and version control; and coordinates periodic data-validation activities with DHCS and program partners.
Other Duties (5%) Performs other duties that are within the scope of this classification, as requested.

Qualifications
All employees shall possess the general qualifications, as described in California Code of Regulations Title 2, Section 172, which include, but are not limited to integrity, honesty, dependability, thoroughness, accuracy, good judgment, initiative, resourcefulness, and the ability to work cooperatively with others.

This position requires the incumbent to maintain consistent and regular attendance; communicate effectively (orally and in writing) in dealing with the public and/or other employees; develop and maintain knowledge and skill related to specific tasks, methodologies, materials, tools, and equipment; complete assignments in a timely and efficient manner; and, adhere to departmental policies and procedures.

Special Requirements

Conflict of Interest (COI)
Background Check and/or Fingerprinting Clearance
Medical Clearance
Travel: 5%
Bilingual: Pass a State written and/or verbal proficiency exam in
License/Certification:
Other:
Competencies

The competencies required for this position are found on the classification specification for the classification noted above. Classification specifications are located on the California Department of Human Resource’s Job Descriptions webpage.