STATE CLASSIFICATION JOB DESCRIPTION


Salary Group B20

Class No. 5528

QUALITY ASSURANCE SPECIALIST III

GENERAL DESCRIPTION

Performs advanced (senior-level) quality assurance work.  Work involves coordinating the planning, development, and administration of internal quality assurance and compliance activities.  May supervise the work of others.  Works under limited supervision, with considerable latitude for the use of initiative and independent judgment.

EXAMPLES OF WORK PERFORMED

Coordinates the timely and ongoing transmittal of completed reviews.

Coordinates quality control case readings and other quality assurance and compliance activities.

Receives case samples selected from multiple financial and medical assistance programs, assigns cases to staff, and monitors the review process.

Provides technical guidance and assistance during the review process.

Evaluates quality control reviews for accuracy and compliance with federal and state requirements.

Evaluates and edits referrals for errors found in cases.

Develops and conducts staff training as new program policies and procedures are implemented or new programs are mandated by the federal government.

Reviews trends and resolves problems regarding the methods of quality control operations or procedures.

Reviews quality control findings and develops corrective action plans.

Prepares reports and maintains records of operations.

May 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 coursework 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 and state program policies and laws, of financial and medical eligibility program policies, and of quality control procedures.

Skill in interviewing, in analyzing data, and in the use of a computer and applicable software.

Ability to plan, coordinate, and administer quality control program activities; to ensure compliance with state and federal regulations; to identify problems and develop solutions; to communicate effectively; and to supervise the work of others.


State Auditor’s Office

Revised 9-1-15