State Quality Control Reviewer I

Introduction

Make a Difference with DHSS

Our mission at the Department of Health and Social Services (DHSS) is to improve the quality of life of Delaware citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. We prioritize personal and family independence by assisting individuals and families in a variety of life areas.

We offer numerous career opportunities and are dedicated to attracting and retaining highly talented individuals who are ready to make a difference in their community today. DHSS is a great place to kick-start your profession.

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Summary Statement Join Our Team as a State Quality Control Reviewer I Are you detail-oriented, tech-savvy, and adept at managing multiple systems? Do you thrive in a dynamic environment where accuracy and compliance are key? If so, this opportunity is for you! As a State Quality Control Reviewer I , you will play a vital role in conducting federally mandated audits for the SNAP public assistance program . Your expertise in data analysis and error detection will help ensure compliance with state and federal regulations while maintaining program integrity. Staying informed on evolving policies is essential to success in this role. This position demands strong analytical skills, exceptional time management, and keen attention to detail . A valid drivers license is required for fieldwork. Essential Functions Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, employees can complete job duties of a similar kind not specifically listed here.

• Conducts reviews of case files, records, and supporting documentation to determine the accuracy of client eligibility factors and public assistance payments within prescribed timeframes using quality control methodology.

• Interprets, explains, and ensures compliance with state or federal laws, rules, and regulations, approved waivers, as well as program requirements.

• Researches, identifies and reviews relevant records or documents and conducts interviews of clients, which may include visiting residences, to obtain and clarify information.

• Performs mathematical computations of income, resources, and expenses to determine the accuracy of benefits payments including re-calculation of regulatory formulas and household budgets; incorporates factors such as fluctuating earnings, child support, shelter costs, utilities, childcare/medical deductions, taxes, and insurance.

• Ensures data validity and evaluates program performance through a variety of quality control methods such as root cause analysis.

• Identifies factors that cause or contribute to errors, discrepancies, and non-compliance and makes recommendations for corrective action and improvements based on findings.

• Prepares and submits program reports that clearly and accurately document findings, supporting facts, and actions taken.

• Completes continuing education to remain current on quality assurance standards, methods, techniques, and best practices in assigned public assistance programs.

• Uses automated information systems and computer software to research, review, analyze, document, and report on public assistance case information.

• Issues recommendations from reviewed cases for future error reduction strategies and improvements to program integrity and escalates cases of suspected fraud.

• Attends fair hearings as needed, testifying to explain findings and calculations of reviewed cases.

• Communicates and interacts effectively with people across cultures, ranges of ability, genders, ethnicities, ages, and races.

• Performs related work as required.

Job Requirements JOB REQUIREMENTS for State Quality Control Reviewer I
Applicants must have education, training, and/or experience demonstrating competence in each of the following areas:

1. One year of experience in interviewing which includes using structured or unstructured interview techniques to obtain facts, explore issues, and identify courses of action.
2. Six months' experience developing, implementing, and managing quality improvement programs such as evaluating the quality of services, identifying problems and needs, and recommending corrective action and improvements to ensure optimum service delivery, goals, and objectives are met and in compliance with applicable laws, rules, regulations, and standards.
3. Six months' experiencein researching, compiling, and analyzing data to make recommendations for continuation or changes to operations, programs, services, policies or procedures based on findings.
4. Six months' experience in determining compliance with laws, rules, regulations, standards, policies, and procedures.
5. One year of experience in math such as addition, subtraction, multiplication, division, percentages, ratios, fractions or decimals.

Additional Posting Information

The State of Delaware recognizes the value of telework and flexible working schedules. This position is eligible for Telework and Alternative Work Schedules according to the State of Delawares Alternative Work Arrangement Policy . More information will be shared at the time of interview.

A writing sample will be requested at the time of interview.

Conditions of Hire

As a condition of hire you must possess a valid driver's license (not suspended, revoked or cancelled, or disqualified from driving).

Applicants must be legally authorized to work in the United States. The State of Delaware participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. For more information refer to our Job Seeker Resources .

DHSS does not provide employment-based sponsorship.

Benefits

To learn more about the comprehensive benefit package please visit our website at

Selection Process

The application and supplemental questionnaire are evaluated based upon a rating of your education, training and experience as they relate to the job requirements of the position. It is essential that you provide complete and accurate information on your application and the supplemental questionnaire to include dates of employment, job title and job duties. For education and training, list name of educational provider, training course titles and summary of course content. Narrative information supplied in response to the questions must be supported by the information supplied on the application including your employment, education and training history as it relates to the job requirements.

Once you have submitted your application on-line, all future correspondence related to your application will be sent via email. Please keep your contact information current. You may also view all correspondence sent to you by the State of Delaware in the My Applications tab at StateJobs.Delaware.gov .

Accommodations

Accommodations are available for applicants with disabilities in all phases of the application and employment process. TDD users may request an auxiliary aid or service by calling ... or by visiting delawarerelay.com . You may also call ... or email ... for additional applicant services support.

The State of Delaware is an Equal Opportunity employer and values a diverse workforce. We strongly encourage and seek out a workforce representative of Delaware including race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression.