Under limited supervision, the Quality Control Reviewer performs comprehensive and full field investigative audits of selected ACA Medicaid unit, and other special program cases and special audits to determine compliance with federal and state regulations.
Preference will be given to candidates with experience in dealing with the ACA Medicaid program. Travel is an essential duty of this position.
Office location will be determined based on the most qualified candidate and the availability of office space at either the local office or an alternative location, if necessary.
As a condition of employment, an inquiry into job related information will be completed, which may include but is not limited to, criminal records, abuse registry records, driving records, employment history and education and training.
Failing to cooperate with this process, providing false or incomplete information or discovery of disqualifying information will result in denial for dismissal from employment or denial or transfer irrespective of when discovered.
Minimum Qualifications
Training : Graduation from an accredited four-year college or university.
Substitution : Experience as described below may substitute for the required training on a year-for-year basis.
Experience : Two years of full-time or equivalent part-time paid employment in responsible eligibility or investigatory work involving credit, insurance, or government programs.
Special Requirement : Availability of a car for continuous use may be a requisite of employment.
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