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#TEX-2593-073933
Supplemental Questionnaire

Last Name
First Name

 

All applicants are required to complete the supplemental questionnaire as part of the online application process. The purpose of the supplemental questionnaire is to determine whether applicants possess the minimum qualifications and the desired experience for the 2593 Health Program Coordinator III (Quality Improvement Specialist) position. This information should be consistent with your application (i.e. must be included in the Education and Training and Employment Record sections) and is subject to verification.

Questions #1a-2b are specifically used to determine whether applicants possess the minimum qualifications for the 2593 Health Program Coordinator III (Quality Improvement Specialist) position.


1a.

Select the statement that best matches the highest level of education you have completed. (One year is equivalent to 30 semester units/45 quarter units.)

No formal college education
Completion of one (1) year of college education
Possession of an Associate's Degree from an accredited college or university or completion of two (2) years of college education
Completion of three (3) years of college education
Possession of a Bachelor's Degree from an accredited college or university
Possession of a Master's Degree or higher from an accredited college or university
1b.

Referring to your response in Question #1a, please provide the name of the school you attended and the field of study for each degree you completed. If this does not apply to you, please type "N/A" in the box below.

2a.

How many months of verifiable full-time equivalent professional level administrative or management experience do you have where your primary responsibilities include overseeing, monitoring, and/or coordinating a program provide health and/or human services? (Full-time is equivalent to 40 hours per week.)

No experience
Less than 24 months
24 to 35 months
36 to 47 months
48 to 59 months
60 to 71 months
72 to 83 months
84 or more months
2b.

Please describe in detail your professional level administrative or management experience with primary responsibility for overseeing, monitoring, and/or coordinating a program providing health and/or human services.


 

The remaining questions are used to assess whether applicants have the desired qualifications for the 2593 Health Program Coordinator III (Quality Improvement Specialist) position. This information will only be used by hiring managers to determine those applicants that most closely meet the needs of the Department.


3a.

Please describe your project management experience.

3b.

Please provide the name of the employer(s) and the dates of employment (e.g. MM/YYYY – MM/YYYY) where you obtained your experience as indicated in Question #3a.

In addition, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you indicated that you do not have any experience, please type "N/A" in the box below.

Do not type “See Resume.”

4a.

Please describe your experience with quality improvement. In your response, please highlight any experience or training with Lean process improvement.

4b.

Please provide the name of the employer(s) and the dates of employment (e.g. MM/YYYY – MM/YYYY) where you obtained your experience as indicated in Question #4a.

In addition, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you indicated that you do not have any experience, please type "N/A" in the box below.

Do not type “See Resume.”

5a.

Please describe your experience in strategic planning, specifically strategy design, implementation and evaluation.

5b.

Please provide the name of the employer(s) and the dates of employment (e.g. MM/YYYY – MM/YYYY) where you obtained your experience as indicated in Question #5a.

In addition, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you indicated that you do not have any experience, please type "N/A" in the box below.

Do not type “See Resume.”

 

CERTIFICATION: I hereby certify that all information is true and based on my education, training, skills, and experience. I understand that any false or incorrect statement may result in my disqualification of the selection process for this position and/or dismissal from employment with the City and County of San Francisco. I also understand and agree that any information provided is subject to verification.