Apply for Eligibility Quality Control Reviewer Role at State of Wisconsin

United States Job Openings

State of Wisconsin

Eligibility Quality Control Reviewer

FULL TIME

October 24, 2024

Introduction

The Department of Health Services (DHS), Division of Medicaid Services (DMS) is recruiting for an Eligibility Quality Control Reviewer in the Bureau of Eligibility Operations and Training (BEOT).
BEOT provides operational and production-based support for eligibility processes and federal requirements. Major areas of support include Income Maintenance (IM) technical and operational support, federal quality control (QC) compliance, IM contract performance monitoring, IM training, and special program eligibility determination.
As an employee of the State of Wisconsin, you'll also have access to an amazing benefits package, including:

3.5 weeks of vacation, 9 paid holidays and ample sick time.
Top rated health plan options starting at $42/month for single plans and $104/month for family plans, after 2 months of state service.
Premium pension plan with at least a 6.9% employer match in 2024. Plus, a tax advantaged supplemental retirement savings plan which allows you to save money directly from your paycheck for retirement. Use this Total Rewards Calculator to see the total value of our competitive benefits package!
Several flex spending accounts: medical, dependent care, commuter, parking and High Deductible Health Savings.
A casual office atmosphere, flexible work schedules, and telework options depending on the position’s requirements.
Well Wisconsin Wellness Program
A free and confidential employee assistance program that offers employees and their immediate family dependents a variety of tools, resources, and professional consultation services to support their health, goals, and overall well-being.
Public Service Loan Forgiveness Program

This position has the ability to work remotely up to 5 days per week but may be required to report to an office location on occasion to complete certain tasks. This position can be headquartered at one of our central or regional offices.

Position Summary

As the Eligibility Quality Control Reviewer, you will be responsible for completing quality assurance reviews of income maintenance programs. The review of these entitlement programs is part of state oversight to ensure compliance with contract performance criteria, identify training needs, and for quality control purposes to determine the accuracy of Wisconsin’s expenditure of federal funds in the Food Share and Medicaid programs. These reviews are also part of federal oversight to measure improper payments in the Medicaid and Children’s Health Insurance Program (CHIP) and Food Share Program. Responsibilities include:

Participating in planning, developing and communicating Income Maintenance (IM)/Quality Control (QC) policy/procedure interpretations and guidelines to internal and external partners.
Participating in project teams on IM/QC policy/procedures, developing and implementing error reduction efforts in conjunction with other sections within BEOT.
Submitting case findings to federal QC officials, consortia and tribal agencies.
Exercising independent judgment and autonomy when making policy interpretations. Accuracy of the quality assurance reviews are critical as they impact the State of Wisconsin’s improper payment rate as well as contract monitoring for the consortia and tribal agencies.

Salary Information

Pay for this position is between $29.50 and $33.35 per hour (approximately between $61,300 and $69,300 per year) depending on qualifications, plus excellent benefits. A 12-month probationary period is required.
Pay for current or former state employees will be based on the rules that apply to compensation for the applicable transaction. This position is classified as an Economic Support Quality Assurance Specialist – Advanced and is in pay schedule and range 12/63.

Job Details

All applicants who may be appointed to this position will be required to allow DHS to conduct a background check to determine whether the circumstances of any conviction may be related to the job being filled.
For positions that allow remote working flexibility, working outside of Wisconsin or in bordering cities will not be allowed except in extremely limited circumstances due to the need to report to an office location in Wisconsin on short notice.
Employees must have access to both a private workspace and secure high-speed internet for remote work option. Mileage reimbursement to the employee’s headquarter location is not provided. Remote work flexibility will be discussed in more detail during the interview process.
DHS does not sponsor work visas for this position, thus, in compliance with federal law, selected candidates will be required to verify eligibility to work in the United States by completing the required I-9 form upon hire.

Qualifications

Minimally qualified applicants will have all of the following:

Experience determining eligibility for economic assistance programs (e.g., Food Share, Medicaid, Badger Care Plus, Child Care, etc.).
Experience working with economic support eligibility determination computer systems (e.g., CARES Worker Web (CWW), KIDS data system, etc.).
Experience performing quality control review and assessment activities related to Food Share or Medicaid.
Experience interpreting and applying federal or state laws, regulations, and policies of Food Share or Medicaid programs.

Well-qualified applicants will also have one or more of the following:

Experience working as a program expert on a workgroup, team, project, or initiative.
Experience with federal Quality Control methods (e.g., quality review evaluation, error reduction methods, etc.) and documentation (e.g., manuals, procedures, reporting requirements, etc.).

Your letter of qualifications is limited to one (1) page. For a guide on developing your resume and letter of qualifications and what should be included in these materials, click here.

How To Apply

Applying is easy! Click “Apply for Job” to start your application process. Sign into your account or create an account before applying for the job. Follow the steps outlined in the application process to submit your application.
Helpful Information:

Once your application is submitted, no changes are allowed. Click “Save” to allow changes to your application as needed before submitting by the deadline.
You may want to save a copy of the job posting for referencing after the deadline.
Submitted materials will be evaluated by a panel of job experts according to the qualifications above.
Please monitor your email for communications related to this position.
Current or former permanent, classified, state employees must complete the online application process to be considered.
If viewing through an external site, please apply directly at Wisc.Jobs.
For technical assistance and general information, please see Frequently Asked Questions. For questions about the position, to request a copy of the full position description, or for other employment inquiries, please contact Allyvia Vang in Human Resources at allyviam.vang@dhs.wisconsin.gov.

DHS is an Equal Opportunity and Affirmative Action employer seeking a diverse and talented workforce.
Veterans are encouraged to apply. For complete information on Veterans’ hiring programs with the WI Department of Veteran’s Affairs, click here.

Deadline to Apply

The deadline to apply is 10/31/24 at 11:59 pm. Applicants are strongly encouraged to allow ample time to finalize their applications keeping in mind that technical assistance is only available Monday through Friday 7:45 am – 4:30 pm. Late or incomplete applications will not be accepted.

We regret to inform you that this job opportunity is no longer available as it has expired

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