Quality Review Analyst (Benefits Quality Review Analyst) (4911-12)

Hamilton County, Ohio•Cincinnati, OH

3d•Onsite

About The Position

This position is responsible for conducting quality assurance reviews related to hearing compliance and Economic Sustainability benefit programs, including SNAP and Medicaid. The analyst will audit hearing files, documentation, timelines, processes, and outcomes to ensure compliance with federal, state, and local requirements, agency policies, and program standards. The role involves identifying gaps, inconsistencies, trends, and areas of noncompliance, and recommending corrective actions or process improvements. Additionally, the analyst will provide technical guidance and support, assist in developing new or revised systems and procedures, and perform other related duties as assigned. This is a full-time position with a competitive benefits package and retirement plan.

Requirements

Bachelor’s degree in public administration, business administration, Social Work, Psychology, Special Education, Therapeutic Recreation, Sociology, Criminal Justice, Human Services (including a clinical practicum of at least one year), or a related field from an accredited college or university plus one (1) year of experience with a Department of Human Services (DHS) (or comparable department); OR One (1) year of experience as a Quality Review Specialist.
Background checks consistent with requirements in OAC 5101:2-5-09 must be completed at employment and every ten years following, including but not limited to the following systems: SACWIS, State Child/Abuse Neglect Central Registry Check for any state in which the applicant resided within the last five years, Ohio Bureau of Criminal Identification Investigation (BCI), FBI, National Sex Offender Public website (WWW.NSOPW.Gov) Code 5101:2-5-09 must be conducted for each prospective employee.

Nice To Haves

Experience working with public assistance programs, including SNAP and Medicaid, and related eligibility and hearing processes.
Experience performing quality assurance, compliance, or program review activities within a human services or public assistance environment.

Responsibilities

Conducts quality assurance reviews related to hearing compliance and Economic Sustainability benefit programs, including SNAP and Medicaid.
Audits hearing files, documentation, timelines, processes, and outcomes to ensure compliance with applicable federal, state, and local requirements, agency policies, procedures, and established program standards.
Identifies gaps, inconsistencies, trends, and areas of noncompliance and recommends corrective actions or process improvements.
Analyzes program practices and existing operations to maintain and improve accuracy, efficiency, compliance, and quality of service.
Prepares written reports summarizing findings, trends, recommendations, and required follow-up.
Develops and implements methodologies for quality review and analysis.
Provides technical guidance and support related to hearing compliance and applicable Economic Sustainability program requirements.
Reviews and interprets established requirements, policies, procedures, and quality standards related to SNAP, Medicaid, and other assigned benefit programs.
Communicates identified deficiencies and recommended corrective actions.
Provides guidance or training regarding hearing compliance requirements, quality standards, and established procedures.
Tracks follow-up activities and compliance trends to support accurate, timely, and consistent application of program requirements.
Assists in the development and implementation of new or revised systems, procedures, programs, tools, and work processes based on quality review findings, regulatory changes, compliance trends, and identified operational needs.
Collaborates with management and appropriate staff to recommend improvements that enhance agency efficiency, effectiveness, compliance, accuracy, and quality of service.
Attends meetings, conferences, and training related to assigned programs, quality assurance, hearing compliance, and other areas of responsibility.
Performs other related duties as assigned.

Benefits

Highly Competitive Employee Benefits Package
Generous Paid Time Off
11 Paid Holidays
40 hours Paid Vacation (if no prior service)
Ohio Public Employee Retirement System (includes 14% Employer Contribution AND a defined benefit option)
Medical
HRA
Dental
Vision
Employer-Paid Life Insurance
Long-Term Disability
Tuition Reimbursement
Paid Parental Leave
Public Service Loan Forgiveness Eligibility
Commuter Stipend or Free On-Site Parking
Wellness Incentives
Robust Employee Assistance Program
Access to Free Medical and Rx through Marathon Health
Expansive Behavioral and Mental Health Resources