Official SealSan Joaquin County Human Resources Division


#0121-RM0203-01
Supplemental Questionnaire

Last Name
First Name
1.

Do you possess a bachelor’s degree from an accredited college or university with a major in biological sciences, health science, nursing, public health, business administration, public administration or closely related field? (If yes, please ensure the degree is listed on your employment application in the education section or on your resume)

Yes No
2.

Do you possess at least three (3) years of progressively responsible administrative or operational experience in a hospital, public health, ambulatory or other medical services clinic area, including one year in a supervisory capacity?

Yes No
3.

Please provide a detailed description of your duties providing supervision to clinical and support staff. Include in your answer: The number of staff supervised, your role in training and/or development of staff, assigning and overseeing workload, your experience in employee performance reports and discipline.

4.

Please provide a description of your experience preparing and maintaining budgets and fiscal data for a healthcare environment.

5.

Please provide a description of your experience in preparing policies and/or procedures in a healthcare setting. Include in your answer: your role in the development process, implementation and training of staff.

6.

Please provide a description of your experience in meeting and collaborating with multiple healthcare organizations and the community.

7.

Please provide a description of your experience working with electronic health records systems.