Sr Economic Support Specialist - Quality Assurance Specialist

Position Summary

Under the general direction of the Quality Assurance Coordinator (QAC) and the supervision of the Consortium Training Supervisor, the Quality Assurance Specialist is responsible for conducting quality assurance (QA) reviews of a monthly assigned sample of Income Maintenance (IM) cases receiving FoodShare (FS) selected through Pro-Certification Review (PCR) Tool. The Quality Assurance Specialist completes the initial quality review process, identifies and corrects eligibility and processing errors, and ensures compliance with federal, state, and consortium policies and procedures.

The position analyzes quality review findings, communicates results to staff and leadership, provides policy and procedure guidance to consortium IM staff, and supports continuous quality improvements efforts through targeted feedback and training recommendations. Working collaboratively with the Quality Assurance Coordinator, Consortium Training Supervisor, and Consortium Leadership Team, the Quality Assurance Specialist assists in developing and implementing quality assurance strategies, identifying error trends, supporting error reduction initiatives, and promoting consistency in eligibility determinations across the consortium. The position also contributes to the development of training materials, participates in special quality improvement projects, and serves as a subject matter resource on FoodShare policy and eligibility requirements.

This position supports the Mission, Vision of the Human Services Department and performs all duties in a manner consistent with the department's professional standards and Commitment to My Co-Workers, fostering a culture of accountability, collaboration, integrity and continuous improvement.

Responsibilities

• 75% - Performs Quality Assurance (QA) Reviews to ensure accuracy and compliance with program policies and procedures:
  • Perform Quality Assurance reviews (QA) on cases open for FoodShare (FS)
  • Utilize the Pre-Certification Review (PCR) tool and/or other QC methods to complete reviews on cases selected from the PCR tool
  • Review and evaluate eligibility determinations, case documentation, processing timelines, and benefit calculations for accuracy
  • Identify and correct any benefit or technical errors found
  • Provide clear, constructive feedback detailing the results of each PCR completed to staff
  • Utilize Wisconsin Department of Health Services (DHS) quality assurance tools, reports, and review systems to monitor program performance and compliance
  • Collaborate with the Leadership team to support process improvement initiatives and training efforts
  • Maintain thorough knowledge of program policies, procedures and eligibility requirements
  • Maintain confidentiality related to the results of the QC reviews
  • Participate in state and local work groups and quality control initiatives to identify error trends and implement systemic improvements
  • Apply and support Southern Consortium quality assurance procedures, workflows, and operational standards
  • Identify trends, deficiencies, and areas of risk within FoodShare case management practices and recommend corrective actions
  • Provide feedback, coaching, and technical assistance to Economic Support staff regarding policy interpretation, eligibility procedures, and quality expectations
  • Develop and maintain quality control reports, audit findings, and corrective action recommendations
  • Monitor changes in FoodShare policy and communicate updates to staff and leadership
  • Assist with staff training related to eligibility determination processes, documentation standards, DHS review expectations, and program compliance requirements
  • Collaborate with supervisors, consortium partners, and management to improve workflow efficiency and program outcomes
  • Participate in internal and external audits and prepare documentation as required
  • Maintain confidentiality of client information in accordance with applicable laws and regulations
  • Ensure compliance with federal, state, and consortium policies and procedures
• 20% - Determine eligibility and provide ongoing case management:
  • Be proficient in all aspects of the Economic Support Specialist position exercising advanced program and policy knowledge
  • Maintain up-to-date knowledge of policy, system, and procedural changes for the FoodShare program and other programs that may impact FoodShare eligibility
  • Provide assistance with questions/problem solving from all levels of FoodShare
  • Provide overview and/or clarification to staff of State policies listed in Operations Memos and policy handbooks
  • Be proactive and communicate to supervisory staff when there appears to be an additional training need of staff
  • Participate in meetings to develop, plan, coordinate, and interpret economic support policies and procedures
  • Develop and supports a strong team environment throughout the Southern Consortium
  • Promote a diverse and inclusive work environment
  • Review for accuracy and completeness
  • Ensure that all data is entered into CWW/CARES system in an accurate and timely manner and that correct payments are issued in a timely manner
  • Complete annual training requirements mandated by the state including but not limited to 12 hours of professional development, cultural competency, civil rights, Social Security Training, and HIPAA
  • Successfully navigate CWW (Cares Worker Web), KIDS, BRITS, CARES Mainframe, Forward Health Portal, DHS Website, SAVE, ECF, Genesys, CCAP, Kelley Blue Book, NADA, DMV, GIS Tax Database, Jail Roster, Department of Correction website, Cornerstone Training, and ACCESS
  • Independently seek out policy changes, Operations Memorandums and CWW process changes for Income Maintenance Programs
  • Ability to apply critical thinking to follow policy and process in various forms
  • Maintain high level of accuracy to meet state and federal performance standards
  • Respond timely to emails and voicemails from the Quality Assurance unit, Supervisor, co-workers and leadership team
  • Respond to Income Maintenance Quality Assurance, FoodShare Quality Control, and Internal Quality Assurance reviews when needed
• 5% - Misc. Duties to meet changing priorities and programs:
  • Other duties as assigned
  • Maintain effective working relationships with Job Center partners, other community programs/resources, and applicants/participants
  • Involved in start up and/or ongoing quality control projects as assigned
  • Other duties as assigned

Success Factors (KSA's)

• Knowledge of Economic Support programs
• Knowledge and ability to work effectively cross-culturally
• Knowledge of the skills and abilities of the Economic Support Specialist
• Knowledge of Southern Consortium processes and operational procedures related to Economic Support Programs
• Strong Knowledge of FoodShare policies, eligibility rules, and public assistance regulations
• Strong organizational, communication, and interpersonal skills
• Knowledge of a variety of software programs, including but not limited to Office Suite and specific programs related to economic support programs
• Proficiency with CWW, related eligibility systems, databases, and Microsoft Office
• Ability to analyze complex information and make sound decisions based on policy and regulations
• Ability to use time management and organizational skills effectively
• Ability to prioritize daily/weekly workload
• Ability to provide oversight and direction of work of others
• Ability to operate as a team member of the Human Services Department
• Ability to establish and maintain effective working relationships with superiors, elected officials, co-workers, subordinates, and the general public
• Ability to demonstrate leadership, professionalism and serve as a role model to ESS
• Ability to gain and maintain the confidence and cooperation of co-workers and administrators
• Ability to learn techniques and acquire skill in evaluating employee performance/progress
• Ability to adapt to a changing environment
• Ability to demonstrate effective customer service skills
• Ability to deal effectively with persons who may be hostile, non-cooperative or evasive

Job Requirements, Education, Training & Experience

• Two years of education from an accredited college or university with major coursework in Human Services, Public Administration, Business Administration, Social Sciences or related fields or minimum four years of experience providing case management and/or eligibility determination of clients or equivalent combination of training and experience
• Must have experience with electronic data processing equipment and use of current computer
• Demonstrate expertise in the functions of ES work

Essential Job Functions (Physical Elements, Equipment And Working Conditions)

• Ability to sit, walk, or stand for long periods of time
• Ability to exert up to 10 pounds of force occasionally or negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects
• Ability to use a computer and computer keyboard
• Ability to use copy and fax machine as well as telephone and scanner
• Work is indoor in a public office building
• Potential exposure to customers that may escalate verbally and/or physically

Salary

• Employees are paid every two weeks on Friday (26 checks in a year)
• Paychecks are directly deposited in the employee's bank account
• There is a two week delay between the pay period worked and the payday
• New employees generally wait four weeks before they receive their first check

Benefits

• Vacation: Employees receive vacation based upon the work group/bargaining unit their job class is assigned to. See attached Appendix A for more information
• Holidays: Most employees receive the following holidays: New Year's Day; Spring Holiday to be observed the Friday immediately preceding Easter; Memorial Day; July 4th; Labor Day; Thanksgiving Day; Friday after Thanksgiving Day; Day before Christmas; Christmas Day; and one Floating Holiday of the Employee's choice. For a list of holidays in the law enforcement units see their Collective Bargaining Agreements
• Health Insurance including our Wellness component: The County is self-insured and offers a network of health care providers through the Alliance Network, which includes: 90 hospitals; 7,000 medical doctors; 13,500 total professional service providers; 3,400 medical clinic sites; 420 chiropractic clinic sites; 580 mental health clinic sites; and 1000 home care agency locations. Pharmacy services are provided by Navitus. The Alliance is a cooperative of more than 240 self-funded employers in Wisconsin, Iowa and Illinois. The Alliance was started in 1990 and has three goals - moving health care forward by controlling costs, improving quality, and engaging

This response is AI-generated, for reference only.