Quality Control Reviewer #W0233 (Repost)

Title:Quality Control Reviewer #W0233 (Repost)

State Role Title: Prog Admin Specialist I

Hiring Range: $51,000 - $59,000 per year (salary commensurate with experience)

Pay Band: 4

Agency: Department of Social Services

Location: PIEDMONT REGIONAL & LICENSING

Agency Website: https://www.dss.virginia.gov/

Recruitment Type: General Public - G

Job Duties

NOTE: This position is not 100% telework. This position may be eligible for telework opportunities; availability, hours, and duration will be in accordance with the Commonwealth's Teleworking policy. The employee is required to work a schedule that is split between remote and onsite.
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.
The QC 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. Review results 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 Revised 10/3/2022 Page 2 of 9 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

Ability to independently manage a deadline-oriented workload with a high degree of accuracy
Proficiency in Quality Control review policies and procedures
Ability to interpret and apply complex state and federal regulations and procedures
Good working knowledge of eligibility requirements for the SNAP and Medicaid programs
Ability to demonstrate effective oral and written communication skills
Excellent 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.
A high degree of computer skills and a valid driver's license are essential
Knowledge of the Temporary Assistance for Needy Families (TANF) and Energy Assistance (EA) programs

Additional Considerations

Good working knowledge of and/or QC experience

Special Instructions

You will be provided a confirmation of receipt when your application and/or resume is submitted successfully. Please refer to "Your Application" in your account to check the status of your application for 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.
This position may be eligible for telework opportunities; availability, hours, and duration will be in accordance with the Commonwealth's Teleworking policy.
To be considered for this position, you must submit a Commonwealth of Virginia application or resume through the on-line "Virginia Jobs" (PageUp) 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 additional considerations as stated in the job announcement. The decision to interview an applicant is based on the information provided. Multiple positions may be filled from this recruitment within 90 days of the closing date.
The Virginia Department of Social Services (VDSS) is an Equal Opportunity Employer and encourages diversity within its workforce.
VDSS does not provide sponsorship.
VDSS is an official certified state agency that 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.
If you have been affected by Policy 1.30 Layoff as a state employee and possess a valid Interagency Placement Screening Form (Yellow Form) or a Preferential Hiring Card (Blue Card), you must submit this document through the "Virginia Jobs" (PageUp) employment site when you apply.

Contact Information

Name: VDSS - Division of Human Resources

Phone: dssrecruitment@dss.virginia.gov

Email: dssrecruitment@dss.virginia.gov

In support of the Commonwealth's commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their Certificate of Disability (COD) provided by a Vocational Rehabilitation Counselor within the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their Certificate of Disability. If you need to get a Certificate of Disability, use this link: Career Pathways for Individuals with Disabilities, or call DARS at 800-552-5019, or DBVI at 800-622-2155.