Human Resource Services Department

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?

This position requires possession of a valid clinical license from the one of the applicable licensing authorities: California Board of Behavioral Sciences, California Board of Psychology, or California Board of Nursing. Please provide the following information in the space below:

• License Title
• Licensing Authority
• License Effective Date
• License Expiration Date

Please describe your post license professional experience as a clinical supervisor coordinating the day-to-day operations and staff coverage of a mental health/behavioral health clinic/program, providing psychiatric, substance abuse, crisis, clinical and case management services, and supervising behavioral health clinicians and other health care professionals. In your response, be sure to include the organization where you worked, duration of experience (employment dates), your title, your role and description of primary related responsibilities, the number of staff and titles of those you supervised.

Describe your experience providing leadership to a multidisciplinary team of behavioral health professionals within a high-volume clinic and/or program providing services to consumers with serious behavioral health issues. Include any specific experience you have working with a large intensive psychiatric case load or working within a juvenile justice mental health setting such as a detention center, or court.

Please tell us what you consider to be the most important characteristics or principles that a clinical and/or program manager working in a behavioral health care system should possess in order to be successful. Describe a situation in which you have demonstrated those characteristics or principles.

I understand in compliance with the Administrative Simplification provision of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as a condition of employment, employees in this classification are required to possess a National Provider Identifier (NPI) number prior to their first day of employment and I am able to meet this requirement.

I understand in Compliance with Medicare regulations, employees in this classification are required to complete the "Medicare Enrollment Process for Physicians and non-Physician Practitioners" through the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services, prior to their first day on the job. I further understand that active enrollment in Medicare is a condition of employment and that failure to attain or maintain active enrollment will result in termination.