Positions in this job family are assigned responsibility for conducting internal and external audits and field investigations and performing federally or state-mandated quality control audits to evaluate the effectiveness of agency programs. Some positions will perform follow-up reviews and advocate for clients and program changes. Duties include investigating welfare fraud and employee violations of agency policy, regulations and applicable state and federal laws. Some positions in this job family will conduct investigations and inquiries to protect the rights of clients, act as client advocate and file grievances on behalf of clients. The Medicaid Services Unit, through contractual agreements with the State Medicaid Agency and the Centers for Medicare and Medicaid Services, assures the health and safety of each program participant and is responsible for ensuring providers offer quality services to all Members. These audits, conducted to safeguard Providers are in compliance with State and Federal rules and regulations, confirm that services are delivered as authorized on the person-centered service plan, that Member needs are being met, that Provider documentation is thorough and complete, and that Members are satisfied with service delivery.
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Job Type
Full-time
Career Level
Mid Level
Number of Employees
1,001-5,000 employees