The incumbent in this position works in the Division of Management Services for the Quality Control Unit. Responsibilities include: conducting federally-mandated reviews of eligibility determinations for Food Benefit and Medicaid applications, denials and terminations; and verifying the work completed by the Division of Social Services and Division of Medicaid & Medical Assistance staff is accurate. The Incumbent will be going out in the field to conduct face-to-face interviews with clients whose cases are being reviewed.
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, incumbents can complete job duties of similar kind not specifically listed here.
- Review/audit public assistance case records and document the nature of all errors so that: the total error rate can be determined.
- Present program methods and procedures can be evaluated; and more effective methods and procedures can be developed and implemented as needed.
- Examine case records to include mathematical computations of incomes, resources and expenses relative to receipt or denial of assistance.
- Schedule home visits with program recipients and interview to verify and/or supplement case record information.
- Make written, telephone and personal collateral contacts with employers, State and Federal agencies, schools etc., in order to substantiate and/or supplement case record information.
- Analyze case determinations for compliance with applicable laws, rules, regulations, policies and procedures of the assistance programs. Completes required federal schedule for each case assignment. Write a summary for each case reviewed detailing the nature of errors as applicable.
- Analyze data accessed from automated information systems.
- Maintain records of cases received with particular emphasis given to review initiation and completion dates.
- Attend staff meetings to discuss laws, rules, regulations and policy interpretations and revisions.
- Make recommendations regarding possible solutions to recurring errors.
JOB REQUIREMENTS for Program Compliance Specialist
Applicants must have education, training and/or experience demonstrating competence in each of the following areas:
- Six months experience in interviewing which includes using structured or unstructured interview techniques to obtain facts, explore issues and identify courses of action.
- Six months experience in making recommendations for continuation or changes to operations, programs, services, policies or procedures based on findings.
- Six months experience in determining compliance with laws, rules, regulations, standards, policies and procedures.
- Knowledge of quality improvement 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 ensure compliance with applicable laws, rules, regulations and standards.
Additional Posting Information
Writing Exercise: A writing exercise will be given 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).
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 www.delawarestatejobs.com.
Accommodations are available for applicants with disabilities in all phases of the application and employment process. To request an auxiliary aid or service please call (302) 739-5458. TDD users should call the Delaware Relay Service Number 1-800-232-5460 for assistance. The State of Delaware – An Equal Opportunity and Affirmative Action Employer.