Official SealHuman Resource Services Department


#18-1485-02
Supplemental Questionnaire

Last Name
First Name
 

Applicants for this position are required to submit responses to the following supplemental questions.  Your completed responses to the supplemental questionnaire will be evaluated to determine your qualifications and must be completed properly in order to be given full consideration for the next phase in the selection process. Additionally, your responses will also be evaluated and used in the selection process in order to identify the best qualified applicants. 

Responses should be thorough and specific.  A lack of detail and explanation in the supplemental questions and in your application may result in failure or disqualification for this position.  Clarity of expression, content, experience, grammar, spelling and the ability to follow instructions will be considered in the evaluation process.  A resume will not be accepted as a substitute for properly completed responses.

Information provided in your responses to the supplemental questionnaire regarding your employment experiences must also be detailed in the Work Experience section of the application for this recruitment.  Please be sure to list all employers and required information, on your application, especially if you are referencing those employers in your responses to the supplemental questions.

The supplemental questions were designed to elicit your experience as it relates to the current recruitment in order to identify the best qualified candidates for this position.  Only the best and most suitably qualified candidates will be invited to participate in the oral interviews. 

By selecting yes below, you certify your understanding that all applicants who meet minimum qualifications are not guaranteed to move forward in the process.  Do you understand the above statement?

Yes No
1.

Do you currently possess an Associate's of Arts degree from an accredited college in health science, social science, or a related field?

Yes No
2.

Please describe your experience assisting clients with application, referral and enrollment processes for federal, state or county health insurance programs. Please indicate the toolsets you have used.

Your response should include:

  • the organization where you gained the experience
  • duration of experience (employment dates/dates you performed these duties)
  • your title, role and description of primary related responsibilities.
3.

Please describe your experience performing health care program outreach activities.

Your response should include:

  • the organization where you gained the experience
  • duration of experience (employment dates/dates you performed these duties)
  • your title, role and description of primary related responsibilities
  • the title of the position you reported to.
4.

Please describe your experience auditing applications for compliance, including the procedures you followed and methods used for proper documentation.

Your response should include:

  • the organization where you gained the experience
  • duration of experience (employment dates/dates you performed these duties)
  • your title, role and description of primary related responsibilities
  • the title of the position you reported to.
5.

Please describe your experience using systems and software related to benefit application and enrollment processes.  Please state the software applications/systems you've used (MEDS, Medslite, AEVS, CAL-WIN, One-e-App) and for what purpose.

Your response should also include:

  • the organization where you gained the experience
  • duration of experience (employment dates/dates you performed these duties)
  • your title, role and description of primary related responsibilities
  • the title of the position you reported to.
6.

Please state the healthcare programs you have knowledge of or experience using (i.e. Medi-Cal, Medicare, CMSP, HealthPac, Kaiser, Covered California, or others).

Your response should include:

  • the organization where you gained the experience
  • duration of experience (employment dates/dates you performed these duties)
  • your title, role and description of primary related responsibilities
  • the title of the position you reported to.
7.

Please describe how you track open items and prioritize competing deadlines. Be sure to indicate the tools and methods you use to ensure timeliness and completeness of assigned work.


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