Quality Assurance Lead Specialist

Salary: Hiring Range: $29.33-$35.19. The maximum pay for this position is $41.06.
Job Type: Full Time
Location: Vail Valley, CO
Publish Date: Posted September 15, 2023

  • Hiring Range: $29.33-$35.19. The maximum pay for this position is $41.06.
     
    The Quality Assurance Lead Specialist reviews client benefit programs for accuracy and rule compliance to minimize any future state audit deficiencies and reinforce the integrity and accuracy in Human Service programs. Identify trends or training issues for other divisions, utilize analytical and technical skills to deliver thorough and comprehensive reviews of program case files performed by the Economic Services Specialists for the Department of Human Services that require the resolution of compliance problems and reconciliation of divergent viewpoints.
     
    Directs the work of the Fraud Prevention/QA Specialist. Communicate regularly with leadership regarding outcomes of eligibility program case reviews, challenges, adaptation of rule changes, and all essential issues. In addition, the Quality Assurance and Compliance Lead Specialist will review data sets to help evaluate trends, promote compliance with State and Federal regulations and identify best practices for the department. 
     
    Schedule: Monday-Friday 8AM-5PM. Eligible for hybrid (remote/in-office) work schedule after 6 month training period. 
     
    Essential Duties
     
  • Conduct case file reviews that enhance payment accuracy and improve program administration by measuring program accuracy and outcomes using standardized tools and proven practices. Ensure compliance with federal, state, and county rules and regulations.
  • Organize and conduct various mandated Human Services program audits following established standards and protocols of the Colorado Department of Human Services (CDHS) and the Colorado Department of Health Care Policy and Financing (CHCPF).
  • Prepare cases and conduct internal audits and case file reviews to ensure that work meets established business requirements and compliance standards.
  • Prepare monthly and quarterly reports based on those reviews and audits. Create and submit CDHS and CHCPF required audit outcome reports.
  • Maintain and consistently enhance knowledge of all programs and systems used within the Department of Human Services, including Colorado Benefits Management System CBMS, Child Care Automated Tracking System (CHATS), HSConnects, etc.
  • Interpret rule changes, apply new rules and verify and revise quality assurance standards, as needed.
  • Compile data and statistics accurately and thoroughly. Report data and statistics to all levels of staff throughout the department.
  • Works with Human Services leadership to address client needs and improve quality assurance best practices and community outreach based on customer service and client and community feedback.
  • Cultivate and disseminate quality assurance best practices and knowledge internally and externally to improve program integrity job knowledge.
  • Identifies, captures, analyzes, and reports critical process metrics and key performance data; conducts regulation reviews, interpretation, and analysis; recommends and monitors Continuous Quality Improvement (CQI) initiatives to improve performance.
  • Cultivate, foster, and maintain positive working relationships with managers, supervisors, employees, and internal and external stakeholders to gain their cooperation and support in assigned projects/studies.
  • Prepare and present written and oral reports regarding recommendations, data, impacts, options, strategies, and outcomes.
  • Prepare and deliver reports, recommendations, or alternatives that address existing and potential trouble areas across the department.
  • Provides program technical assistance to the Economic Services Unit in collaboration with the Economic Services leadership team and trainer and assists with ongoing eligibility program training needs as necessary.
  • Develop and continuously improve knowledge of public assistance programs via participation in self-directed and department-sponsored training conferences and webinars, and reviewing relevant rules and regulations found in the Colorado Code of Regulation and communications from CDHS and CHCPF.
  • Work closely with the Quality Assurance & Fraud Coordinator department to help identify and build cases for potentially fraudulent actions that have the potential to cause abuse or waste of the resources of the County assistance programs.
  • Collaborate in the development of systems to monitor program expectations/outcomes and quality standards, assist in developing methods by which program quality and success will be measured.
  • Serve as a backup to other Quality Assurance and Fraud Coordinators while absent.
  • Serves the community by demonstrating Eagle County Government’s mission and core values and following relevant policies and procedures.
  • Directs the work and tasks of the Fraud/QA Specialist (training, monitoring for consistency/accuracy etc..)
  • Performs other duties as assigned.

Qualifications

Education, Experience, Licensure, Certification, or Registration:

  • Graduation from high school or the possession of a GED, HiSET or TASC Certificate, minimum requirement.
  • Associate’s Degree or Bachelor’s degree in Business Administration, Accounting or Public Administration, or a related field, or an equivalent combination of experience and education is preferred.
  • In addition to the minimum, any or all of the following would help support this role:
    • Four years of experience in determining eligibility for public assistance or Human Services programs or a combination of education and related work experience.
    • Knowledge of program eligibility rules for Supplemental Nutrition Assistance Program (SNAP), Financial Assistance (FA), Temporary Assistance for Needy Families (TANF),
    • Medical Assistance (MA), Child Care Assistance Program (CCAP), and/or other public benefits programs
    • Additional appropriate education may be substituted for the minimum experience requirements
  • An equivalent combination of education and work experience that satisfy the requirements of the job may be sufficient.
  • Bilingual skills preferred (English and Spanish)
  • Ability to work collaboratively with colleagues
  • Well-developed written and verbal communication skills
  • Must be able to pass a criminal background check

Knowledge, Skills and Abilities:

  • Extensive knowledge of rules and regulations for various department programs, including but not limited to IV-E, Food Assistance, Medical Assistance, Temporary Assistance for Needy Families, Adult Financial, Long Term Care, Claims, Medicare Savings Program, Low Income Child Care and Child Support Enforcement Intake.
  • Ability to correctly interpret and apply rules, regulations, and state and federal statutes.
  • Ability to analyze and see trends in various types of data and recommend follow-up steps in response to conclusions reached.
  • Effective oral and written communication skills.
  • Ability to maintain a high level of accuracy, work production and confidentiality.
  • Ability to balance and manage competing priorities.
  • Knowledge of statistics and data collection.
  • Ability to graphically represent data, trends, and conclusions.
  • Strong knowledge of auditing best practices and methodologies.
  • Keen attention to detail.
  • Work in a team-oriented and collaborative environment.
  • Ability to prioritize and execute tasks in a high-pressure environment.
  • Delivers information effectively and timely in a variety of formats and settings including presentations, memos, analytical reports, and decision documents.
  • Ability to establish, maintain and foster positive and harmonious working relationships with those contacted in the course of work.
  • The Quality Assurance Lead Specialist is expected to work under minimal supervision and to exercise independent judgment and a high degree of initiative within established procedures

Culture & Benefits 

Working in local government is one of the best career paths in the mountains. ‘Your Career will Soar with Eagle County’. Get started with us today! 

  • Why is Eagle County recognized as a Best Place to Work in 2022? Culture of flexibility and support for mental health / wellness. Check out more awards here.
  • Purpose! A modern, values-driven workplace with more than 550 employees embracing a welcoming culture, supportive leaders and an organization focused on our mission: Creating a Better Eagle County for All. 
  • Learning organization focused on professional development opportunities, FREE CMC classes and Tuition reimbursement. 
  • Future focused with our Strategic Plan on improving housing, climate change and more.
  • As a certified healthy workplace, our culture recognizes the importance of individual needs and enjoying life outside of work. Other perks may include flexible work arrangements, paid volunteer time, and daytime fitness classes/bike rides.

 

Diversity, Equity and Inclusion 

The County is committed to fostering, cultivating and preserving a culture of diversity, equity and inclusion. We strive for a healthy and prosperous community that promotes all people having equitable access and opportunity. This starts with our internal practices and work. All employees of the County have a responsibility to treat others with dignity and respect at all times. All employees are expected to exhibit conduct that reflects inclusion during work, at work functions on or off the work site, and at all other County-sponsored and participative events 

Great benefits! See the details 

  • Comprehensive and low-cost medical, dental, and vision insurance (as low as $75/month for employee only)
  • Wellness program where you can earn cash or extra days off
  • 12 paid holidays
  • Paid time off (starting at 12 days) and additional medical leave 
  • Paid volunteer hours
  • 8% (dollar for dollar match) retirement plan
  • Free classes at Colorado Mountain College
  • Eagle County University classes (internal trainings) 
  • Tuition reimbursement programs
  • Bilingual Pay Incentive
  • Free bus pass and more

Eagle County is proud to be an Equal Opportunity Employer. Working in a diverse, respectful and inclusive environment is essential for our employees to be successful in serving our community. We do not discriminate with regard to age, race, color, religion, sex, sexual orientation, gender identity or expression, genetics, national origin, disability, veteran status or any other legally protected status. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of this position. 

Relocation & Housing Information

Job Benefits

  • Education / Training
  • Health Insurance
  • Hiring Bonuses

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