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

Hamilton County Government•Cincinnati, OH

3d•Onsite

About The Position

This role is for a Quality Review Analyst within the Job & Family Services department. The position focuses on ensuring compliance with federal, state, and local requirements for Economic Sustainability benefit programs, including SNAP and Medicaid. The analyst will conduct quality assurance reviews, audit files and processes, identify areas of noncompliance, and recommend corrective actions. The role also involves providing technical guidance, supporting process improvement initiatives, and attending relevant meetings and training.

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.
Knowledge of quality improvement practices.
Knowledge of HCJFS/ODJFS PC systems and applications.
Knowledge of applicable federal, state, and local regulations and program requirements.
Knowledge of agency policies and procedures.
Knowledge of human services structure and processes.
Knowledge of quality assurance and compliance practices.
Knowledge of office practices and procedures.
Knowledge of employee training and development.
Skill in analysis of statistical files, data and reports and system processes.
Ability to analyze and interpret program requirements, policies, procedures, and quality standards.
Ability to identify gaps between established requirements and existing practices.
Ability to audit files, documentation, processes, and outcomes for accuracy, timeliness, completeness, and compliance.
Ability to identify actionable challenges and potential solutions.
Ability to analyze trends and recommend corrective actions or process improvements.
Ability to deal with many variables and determine specific actions (e.g., research, production).
Ability to calculate fractions, decimals & percentages.
Ability to use statistical analysis.
Ability to understand manuals and verbal instructions.
Ability to gather, collate & classify information about data, people or things.
Ability to work alone.
Ability to collaborate effectively with a wide range of staff, managers, administrators, and program partners.
Background screening required.

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