Please complete the following supplemental questionnaire. This questionnaire is considered an extension of your employment application and will be reviewed to help assess your qualifications. Resumes are not accepted in lieu of completing this questionnaire.
1a.
License
PATTERN I
To qualify under this pattern, you must possess and maintain a valid license as a Licensed Clinical Social Worker (LCSW), Marriage and Family Therapist (MFT), or Licensed Professional Clinical Counselor (LPCC) issued by the California Board of Behavioral Sciences. Please select from the following the current and active registration you possess:
Licensed Clincial Social Worker (LCSW)
Marriage and Family Therapist (MFT)
Licensed Professional Clinical Counselor (LPCC)
Provide your registration number and expiration date. (Note: Applications pending registration will not be accepted as qualifying)
1b.
PATTERN II
To qualify under this pattern, you must possess and maintain a valid California license as a Psychologist issued by the California Board of Psychology. Please provide your license number and expiration date.
THE FOLLOWING IS REQUIRED FOR BOTH PATTERNS.
2.
Graduation from an accredited university with a master's or doctorate degree in social work, counseling, psychology or other course of study acceptable to the State of California Board of Behavioral Sciences toward licensure as a Licensed Clinical Social Worker (LCSW), Marriage and Family Therapist (MFT), Licensed Professional Clinical Counselor (LPCC), or Psychology is required. Please provide the following information:
Name of college or university from which you graduated
Degree obtained
Major
3.
Candidates must possess and maintain a valid California driver's license. Provide your license number and expiration date.
4.
In addition to full time vacancies, this list may also be utilized to fill part-time opportunities in the County. Please indicate if you are willing to accept part-time opportunities. Accepting part time employment will not exclude you from other full-time opportunities.
Yes
No
5.
Please check boxes that you have qualifying experience in:
Behavioral Health Clinics, programs, or contract agencies serving persistently mentally ill clients
Quality assurance or utilization review activities
Managed care or insurance plans (Kaiser, Health Plan of San Joaquin, Health Net)
Grievances, beneficiary rights and consumer complaints investigations/ resolution
Transitional care coordination between inpatient/ outpatient levels of care for medical complexity or severe persistent mentally ill adults and children
Do you have experience in any of the following? Please check all boxes that apply
Organize and Conduct onsite QA audits
Review current trends, research, and issue treatment/ prevention in relation to QA/QM/QI in a managed Behavioral Health Care System
San Joaquin County Human Resources Division