Official SealDepartment of Budget and Management


#21-005485-0001
Supplemental Questionnaire

Last Name
First Name

 

Below you will find supplemental questions relating to the education and experience that is required and/or preferred for this position.  The intent of the supplemental questionnaire is to provide applicants with the opportunity to elaborate on the specific education/experience possessed, as it pertains to duties of the position.  

Please provide a full answer to every question and refrain from indicating "See Resume".  Answers received on the supplemental questionnaire must correspond to the information provided on the resume, including name of employer, dates of employment, and hours worked per week. Any employment that is listed on the supplemental questionnaire but not included in the resume will not be credited. 

Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.


1.

Do you possess a Bachelor's degree from an accredited college or university?

Yes No
2.

Do you possess Doctor of Philosophy (PhD) Degree, Medical Doctor (MD) Degree, Doctor of Osteopathic Medicine (D.O.), Juris Doctorate (JD) Degree, Master of Business Administration, Master of Public Health, or Master of Health Administration Degree?

Yes No
3.

If you possess an advanced degree from an accredited college or university, please list below.

4.

Describe your professional experience overseeing hospital and/or residential health services.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

5.

Describe your experience at the supervisory or managerial level.

Please include name of employer, job title, dates of employment, and hours worked per week. If you do not possess experience in this area, put N/A in the box below. 

6.

Describe your experience successfully managing one or more acute care or psychiatric health care facilities accredited by the Joint Commission.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

7.

Describe your experience developing comprehensive and large scale reports and presentation for executive level leadership.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

8.

Describe your experience addressing licensure and accreditation issues at acute care or speciality health care facilities.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

9.

Describe your knowledge of and experience with behavioral health management practices and clinical operations.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.


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