Job
Descriptions
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Human
Services Quality Control Analyst
Performs complex quality control analysis review work. Work involves coordinating staff in verifying eligibility determinations for agency programs and functioning as a consultant on advanced quality control reviews. May assign and/or supervise the work of others. Works under limited supervision with considerable latitude for the use of initiative and independent judgement.
MAJOR DUTIES
- Receives monthly case samples selected from multiple
financial and medical assistance programs, assigns cases to staff, and monitors
the review process.
- Provides guidance to staff during the review process.
- Interprets policies from multiple programs for staff.
- Evaluates completed reviews for completeness, accuracy, and documentation.
- Evaluates and edits referrals for errors found in cases.
- Prepares reports.
- Functions as a quality control case review consultant; identifies trends or
problems; and recommends appropriate changes in service delivery.
- Attends and serves as a consultant for corrective action meetings and service
improvement activities.
- Trains new staff and instructs experienced staff in new procedures.
- Maintains records of unit operations.
- Conducts meetings and holds regular conferences with staff.
- Obtains supplies, equipment, and related logistical support.
- Oversees the timely and ongoing transmittal of completed reviews.
- Assists in developing collateral sources of information.
- May assign and/or supervise the work of others.
- Performs related work as assigned.
GENERAL QUALIFICATION GUIDELINES
Experience and Education
Experience in social service financial eligibility determination, auditing, or investigating work. Graduation from an accredited four-year college or university with major course work in social work or a related field is generally preferred. Experience and education may be substituted for one another.
Knowledge, Skills, and Abilities
Knowledge of federal program policies; of office management and administrative procedures; and of human resource policies and procedures and their applications.
Skill in interviewing.
Ability to assign and/or supervise the work of others; to analyze and evaluate the application of policies to determine compliance; to review, analyze, and interpret information and to arrive at logical conclusions; to interpret policies and procedures; to evaluate information pertinent to determining validity of cases and appropriateness of benefits provided; and to evaluate documentation of case reviews and determine if appropriate decisions were made.
