Official SealDepartment of Budget and Management


#16-002942-0002
Supplemental Questionnaire

Last Name
First Name

 

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1.

Do you have a Bachelor's degree from an accredited college or university in nursing, social work, psychology, education or counseling?  (This information must be listed on your application in order to receive credit.)

Yes No
2.

Describe your experience with professional work in health or medical services in areas, other than Mental Health, Developmental Disabilities or Addictions. 

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.

3.

Do you have at least four (4) years of health services experience at the managerial or supervisory level?  (This information must be listed on your application to receive credit.)

Yes No
4.

If you answered "yes" to the previous question, describe your experience below.  Please include name of employer(s), job title(s), dates employed, and the number of hours worked per week for each relevant position.  If you do not have this experience put N/A in the box below.

5.

Do you have at least two years of budget experience that includes developing and implementing fiscal tracking systems to monitor expenditures?

Yes No
6.

If you answered "yes" to the previous question, describe your experience below.  Please include name of employer(s), job title(s), dates employed, and the number of hours worked per week for each relevant position.  If you do not have this experience put N/A in the box below.

7.

Describe your experience responding to audit findings.  Include name of employer, job title, dates employed, and hours worked per week.  If you do not have this experience, put N/A in the box below.

8.

Describe your experience monitoring complex IT system contracts.  Include name of employer, job title, dates employed, and hours worked per week.  If you do not have this experience, put N/A in the box below.

9.

Do you have experience supervising technical IT staff?

Yes No
10.

If you have experience supervising technical IT staff, please list the job titles of those under your supervision.  Include where you were employed in this role, your job title as supervisor, job titles of those supervised, dates employed, and hours worked per week.  If you do not have this experience, put N/A in the box below.

11.

Describe your experience making recommendations concerning new or revised regulations.   Include name of employer, job title, dates employed, and hours worked per week.  If you do not have this experience, put N/A in the box below.

12.

Describe your experience working with public health programs.   Include name of employer, job title, dates employed, and hours worked per week.  If you do not have this experience, put N/A in the box below.

13.

Describe your professional knowledge and experience with cancer diagnosis and treatment.   Include name of employer, job title, dates employed, and hours worked per week.  If you do not have this experience, put N/A in the box below.


Powered by JobAps