Title:  Quality Assurance & Compliance Specialist- Hybrid Work Model

GENERAL DESCRIPTION OF JOB:

Under limited supervision, the Quality Assurance and Compliance Specialist applies analytical and technical skills to deliver detailed and comprehensive reviews of program case files for the Department of Human Services and external auditing agencies that require a resolution of compliance problems and reconciliation of divergent viewpoints. In addition, the Quality Assurance and Compliance Specialist will compile data using recommended methodologies and software programs as required by the requesting internal or external agency to help evaluate trends, promote compliance with State and Federal regulations and identify best practices. This position is responsible for ensuring eligibility and payments for clients meet program requirements.

DUTIES:

• Conduct case file reviews that enhance payment accuracy and improves program administration by measuring accuracy and outcomes using standardized tools and proven practices.
• Maintain and consistently enhance knowledge of all programs and systems used within the Department of Human Services including Trails, ASCES, CBMS, CHATS, HSConnects, etc. and corresponding eligibility program area.
• Consistently advances understanding of program rules in order to interpret changes, implement and apply new rules, and ensure that quality assurance standards are appropriately maintained and revised.
• Accurately and thoroughly gather data and statistics, disseminating information to staff across all levels within the department. Collaborate with Human Services leadership to enhance client services and community outreach initiatives, drawing on feedback from customer service, clients, and the community to refine best practices.
• Develop and share expertise on quality assurance best practices both within and outside the organization. Working alongside supervisors and managers in unit meetings focusing on quality assurance, providing information, gathering feedback, and delivering customized audit training to department staff in order improve adherence to program standards.
• Execute internal audits, deliver reports and recommendations that tackle both current and future challenges throughout the department, including potential risks, internal and external fraud, operational, and compliance issues.
• Serve as a liaison with the State Department of Human Services, Department of Health Care Policy and Financing, and other designated county auditors to execute, oversee and report detailed internal and external auditing data.
• Serve as a backup to other Quality Assurance and Compliance colleagues in his/her absence.

REQUIREMENTS:

Education and Experience:  

• Associate Degree in Business Administration or related field
• At least 2 years of relevant experience determining eligibility for Human Services Programs (Colorado Works, MAGI, SNAP, Adult Financial, CCAP, Child Support, IV-E, etc.)
• Knowledge in 2+ eligibility programs (SNAP, MAGI, Adult Financial, Colorado Works, CCAP etc.)
• Any equivalent combination of education and work experience that satisfy the requirements of the job will be considered. 

Pre-Employment Additional Requirements:

• Must successfully pass pre-employment testing which includes an acceptable motor vehicle record (MVR) and background check.

Post-Employment Requirements:

• Will require fingerprinting and a Colorado Bureau of Investigation (CBI) background check.

WORK ENVIRONMENT:

• Work is generally confined to a standard office environment.

PHYSICAL DEMANDS:

The following are some of the physical demands commonly associated with this position.

• Spends 50% of the time sitting and 50% of the time either standing or walking.
• Occasionally lifts, carries, pulls, or pushes up to 20 lbs.
• Occasionally uses cart, dolly, or other equipment to carry in excess of 25 lbs.
• Occasionally climbs, stoops, kneels, balances, reaches, crawls and crouches while performing office or work duties.
• Verbal and auditory capacity enabling constant interpersonal communication through automated devices, such as telephones, radios, and similar; and in public meetings and personal interactions.
• Constant use of eye, hand and finger coordination enabling the use of automated office machinery or equipment.
• Visual capacity enabling constant use of computer or other work-related equipment.

Definitions:

• Occasionally: Activity exists less than 1/3 of the time.
• Frequently: Activity exists between 1/3 and 2/3 of the time.
• Constantly: Activity exists more than 2/3 of the time.