Quality Control Reviewer, Compliance Division, Eastern Regional & Licensing Office W0304 Multi-hire

Quality Control Reviewer, Compliance Division, Eastern Regional & Licensing Office

At the Virginia Department of Social Services, we put people at the center of everything we do. We believe that every Virginian can live a life of dignity and that all voices, ideas and experiences contribute greatly to our pursuit of excellence. Inspired by continuous improvement, we commit ourselves to listening, learning and cultivating environments of trust, respect and positive engagement. Together, we are mission-driven, eager to achieve, and passionate about bringing the best of who we are to those we serve. We design and deliver high-quality human services that help Virginians achieve safety, independence and overall well-being. We are a $2 billion agency one of the largest in the Commonwealth of Virginia partnering with 120 local departments of social services and 31 community action agencies, along with faith-based and non-profit organizations, to promote the well-being of children, adults, and families statewide. We proudly serve alongside 1,650 (state) and 12,200 (local) human services professionals throughout the Social Services System, who ensure that thousands of Virginia's most vulnerable citizens have easy access to the services and benefits available to them. In addition to a rewarding work experience, VDSS offers excellent health and life insurance benefits, pre-tax spending accounts, state funded Short- and Long-Term Disability, paid holidays, vacation, tuition assistance, free wellness programs, and a state retirement plan with options for tax-deferred retirement savings including employer matching Employee Benefits.

About the Position : The Quality Control Reviewer (QCR) conducts reviews of Local Department of Social Services (LDSS) cases in the Supplemental Nutrition Assistance Program (SNAP), Medicaid and other programs, as mandated or directed, to evaluate LDSS performance. Performance is measured by accuracy of expenditures, timeliness of benefit delivery, and compliance with federal mandates and state guidelines utilizing methodology that ensures program integrity and non-bias. The QCR identifies procedural misunderstandings by LDSS, describes performance trends, discrepancies in policy and refers questions of program abuse for fraud investigation. Reviews results and provide a systematic method of measuring the validity of Virginia's performance in state and federally funded programs and assists with the development of program corrective action measures. As mandated by the United States Center for Medicare and Medicaid Services (CMS), pilots are developed for review of Medicaid populations and sub-programs each fiscal year. The QCR review-findings are utilized by CMS and management in both VDSS and the Virginia Department of Medical Assistance Services (DMAS) in the statewide assessment of Medicaid program performance and appropriateness of expenditures. US Department of Agriculture (USDA) Food and Nutrition Service (FNS) utilizes QCR review findings to determine the SNAP error rate for Virginia which is compared to other state error rates. The work of Virginia's QCR is subject to re-review by USDA; approximately 50% of active case reviews, 40% of closed case reviews and 100% of case reviews that are not completed are sub-sampled. Errors in the QCR's work identified by USDA may cause the state error rate to increase because of the complex federal regression formula utilized by USDA. Therefore, an extraordinary level of programmatic knowledge as well ability to thoroughly review and evaluate case records for accuracy is required for individuals in this position and will provide direct support to Benefit Programs in the way of data for programmatic corrective action and staff training.

Minimum Qualifications

Must have demonstrated :

Relevant knowledge and or experience in the social sciences or related field or an equivalent combination of training or work experience.

Working experience with or demonstrated knowledge of the Supplemental Nutrition Assistance Program (SNAP) and the Medicaid Programs.

Ability to independently manage a deadline-oriented workload with a high degree of accuracy.

Proficient in Quality Control review policies and procedures with the ability to interpret and apply complex state and federal regulations and procedures.

Good working knowledge of eligibility requirements for the SNAP and Medicaid programs.

Extensive investigatory and analytical skills.

High level of interpersonal skills to elicit cooperation of diverse customer populations and interested third parties.

Ability to work effectively with high-level professional staff from both the private and public sectors.

Extensive skills in the use of computers.

Ability to communicate effectively orally and in writing.

Valid driver's license.

Additional Considerations

Good working knowledge of SNAP / Medicaid eligibility programs and Quality Control experience a plus. Knowledge of the Temporary Assistance for Needy Families (TANF) and Energy Assistance (EA) programs is beneficial.

Special Instructions

You will be provided a confirmation of receipt when your application and / or rsum is submitted successfully. Please refer to "Your Application" in your account to check the status of your application for this position.

To be considered for this position, you must submit a Commonwealth of Virginia application or resume through the on-line "Virginia Jobs" (RMS) employment site no later than 11 : 55 p.m. on the closing date listed. Each application is reviewed for documentation that shows the applicant meets the minimum and preferred qualifications stated in the job announcement. The decision to interview an applicant is based on the information provided. This website will provide a confirmation of receipt when the application is submitted for consideration. Please refer to your RMS account for the status of your application and this position. Selected candidate(s) must successfully pass a fingerprint-based criminal history background check. A record of criminal history does not automatically bar an applicant from consideration. Employment verification will be conducted to include current / previous supervisory employment reference checks. VDSS will record information from each new employee's Form I-9 (Employment Eligibility Verification) into the Federal E-Verify system to confirm identity and work authorization. Selected candidate may be required to assist the agency or state government generally in the event of an emergency declaration by the Governor. This position may be eligible for telework opportunities; availability, hours, and duration will be in accordance with the Commonwealth's Teleworking policy on a case-by-case basis. VDSS values the service and experience of our Veterans. As such, Veterans are encouraged to apply and receive preference in the hiring process. AmeriCorps, Peace Corps and other national service alumni also are encouraged to apply. Reasonable accommodations are available to applicants, if requested, during the application and / or interview process. Virginia Department of Social Services does not provide sponsorship. The Virginia Department of Social Services is an Equal Opportunity Employer and encourages diversity within its workforce. We are a "Virginia Values Veterans" (V3) official certified company and state agency that provides hiring preference to Veterans and Members of the Virginia National Guard in support of Executive Order 29, (2010). If you are a Veteran or Virginia National Guard Member, we urge you to respond accordingly on your state application or resume. Minorities, Individuals with disabilities, Veterans and people with National Service experience are encouraged to apply. For more information about our employment practices, please visit our "Vision, Mission and Strategic Plan". Multiple positions may be filled from this recruitment within 90 days of the closing date.