Job Information
Adams County Government Program Integrity Lead - 161783 in Westminster, Colorado
Program Integrity Lead - 161783
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Program Integrity Lead - 161783
Salary
$59,845.45 - $86,775.90 Annually
Location
Westminster, CO
Job Type
Regular Full-time
Remote Employment
Flexible/Hybrid
Job Number
06575
Department
Human Services
Division
HS Investigation and Recovery
Opening Date
06/24/2024
Closing Date
7/8/2024 4:30 PM Mountain
Our Mission
At Adams County, our team members engage in top-notch opportunities to grow and expand their impact. We cultivate an inclusive and innovative culture where diversity matters! Diversity, Equity & Inclusion (DEI) is a core cultural competency at Adams County, and we actively seek and welcome applicants that bring diverse experiences and value inclusion.
Cultural Competencies/EEO
Adams County is an equal opportunity employer. We strive to have a workforce that reflects the community we serve. No person is unlawfully excluded from employment opportunities based on race, color, national origin, ancestry, religion, creed, sex, sexual orientation, gender expression, gender identity, age, disability, genetic information, veteran status,marital status or any other legally protected characteristic.
Position classification
Remote First -- Job duties and expectations require very limited to no time in the office. There may be scheduled infrequent exceptions which require the employee to be onsite.
Description
Benefits
Questions
What Success Looks Like In This Job
This position is designed for the experienced Community Support Case Manager who is highly skilled in the development, training, and accurate and timely issuance of all programmatic benefits. The successful candidate will work in both an independent and team-oriented atmosphere while utilizing strong behavioral and analytical skills to ensure the ethical and e?cient operation of our public assistance programs including Medicaid, SNAP, Colorado Works, and Adult Financial. Develop and implement strategies to prevent fraud, waste, and abuse within these programs, while also ensuring compliance with regulatory standards and guidelines. This role requires a keen attention to detail, strong analytical skills, and the ability to collaborate with various stakeholders to uphold program integrity and enhance service delivery. This position will assist in development and performance analysis of all Community Support Case Manager and Program Integrity team members, which includes developing trainings, providing direction to team members and classroom management, performing reviews on claims, investigation referrals, investigation reports, and benefit recovery and reissuance, as well as audit preparation, trend analysis, and preparing information for court hearings. The candidate is expected to remain highly proficient with all current and future program policy requirements as well as in the use of analysis tools, including Microsoft Excel, Access, and other databases, computer systems, and training methods.
Examples of Duties for Success
Maintain extensive and up-to-date knowledge of all program areas, rules, and processes to successfully train, coach, and support by fielding questions regarding topics such as case processing, interviewing, rule, claims, hearings, and investigations from all Community Support team members, including those in Program integrity and Lead Workers.
Creatively develop and implement fraud detection and prevention strategies to safeguard program funds and resources.
Carefully complete monthly reports that are instrumental in identifying potential fraud and preventing fraud, including monitoring cases over extended periods of time for trends and patterns, as well as other state/federal reporting.
Explore trends to identify areas of risk or vulnerability within program operations, referring for investigation and/or recommending corrective action.
Collaborate with State representatives to obtain approval on educational prevention material, advertisements, and social media posts that are distributed to the public.
Diligently track, monitor, and report on investigation and benefit recovery work to ensure timely action is taken for each task based on county processes/expectations and in accordance with State and Federal Rules/guidelines.
Meticulously review validity and accuracy of claims according to program rule and established processes, then provide one-on-one training.
Thoroughly review investigation reports completed by investigators for accuracy according to program rule and established processes, then provide one-on-one training.
Thoughtfully review investigation referrals and provide one-on-one training.
Analytically review cases determined to have an Intentional Program Violation for accuracy according to program rule and established processes, then provide one-on-one training.
Deliberately collaborate with the Quality Assurance and Training supervisors to create, implement, and facilitate sessions focused on best practices for creating claims, sending investigation referrals, and fraud prevention strategies.
Precisely complete reissuance of benefits for victims of 3rd party EBT card fraud.
Actively maintain extensive knowledge in all areas of Community Support to be able to assist in investigating allegations of possible program eligibility abuse and fraud and take all necessary action as a result of findings, enforcing the collection of public assistance overpayments and fraud, testifying at hearings and county conferences, and providing all needed coverage.
Work closely and communicate regularly with the Program Integrity manager regarding findings on completed reviews, fraud prevention work, training, as well as perform special tasks as requested.
Qualifications for Success
Knowledge of:
Eligibility rules and regulations for all assistance programs is required and includes:
Adult Financial
Colorado Works
Food Assistance
Medical Assistance
Case processing policies and procedures.
Office and internal policies and procedures.
Research and interpret rule.
Research and analyze complex issues for purposes of developing curriculum, facilitations, project plans, claims, trends, etc.
Develop and deliver curriculum to meet key learning objectives and to strategically create connection points to the County’s goals and initiatives.
Utilize and train others to employ all research tools used in eligibility determination and apply those tools to information discovered through investigation and examination.
Apply basic math and read, interpret, and apply manual regulations.
Work quickly and accurately, with minimal supervision at times, to complete time-sensitive tasks.
Differentiate between relevant and non-relevant information when reviewing investigation cases, hearings, intentional program violations, and claims.
Input data accurately and detect errors/make corrections.
Maintain objectivity and confidentiality.
Detail-oriented with a high level of integrity and ethical standards.
Strong organization, time management, and prioritization skills.
Appropriate skills related to delivering excellence in customer service.
Exceptional communication and interpersonal skills, with the ability to build effective relationships with diverse stakeholders.
Excellent skills in logic with the ability to interpret data and identify patterns or discrepancies.
Bilingual in English/Spanish preferred.
More Qualifications for Success
Experience:
At least three (3) years of experience determining eligibility for multiple programs.
Community Support Case Manager III or Lead with consistently high productivity and case accuracy rates is preferred.
Working experience and knowledge of all programs – Adult Financial, Colorado Works, Food Assistance, and Medical Assistance. Experience with LTC is preferred but not required.
Education and Training:
High school diploma or GED equivalent required.
An associate or bachelor’s degree is strongly preferred and may substitute for one year of required experience.
Additional analytical, statistical, or other related higher education is preferred.
License or Certificate:
None
Background Check :
Must pass a criminal background check
Other:
Ability to work in a standard office environment
Adams County provides a comprehensive benefits package to employees that goes above and beyond what is offered at most organizations.
Clickhere (https://youtu.be/ILAvllPaGb4) to watch our video about why Adams County is an Employer of Choice!
Benefits You Expect:
AFLAC Supplemental Medical Insurance
Basic Term Life & Optional Term Life Insurance
Deferred Compensation Plan
Dental/Vision/Medical Plans
Generous Vacation/Sick leave
Long-Term Disability
Retirement Plan
Short-Term Disability
Plus some you might not expect:
Employee Assistance Program
Employee Fitness Center
Employee Health Clinics
Flexible Work Schedules
Recreation Center Discounts
Training & Tuition Reimbursement Programs
Wellness programs
Lactation friendly certified workplace
01
Please be aware that your cover letter and resume will not be accessed in the initial screening process, so you must complete your application and supplemental questions with as much detail as possible. Any personally identifiable information (PII) such as name and address will be redacted from applications that meet the minimum screening requirements and are forwarded to the hiring manager. If the hiring manager selects you to advance in the hiring process, your cover letter and resume will then be accessible to the hiring team. Information provided on the application is used to determine if a candidate meets minimum qualifications. Only information provided at the time of the application being completed will be considered and additional information that is not listed on the application will not be considered when deciding if a candidate meets or does not meet the qualifications. Applicants are STRONGLY encouraged to include all information and details on their application. I understand and agree that only information provided at the time of my application will be used to determine if I meet the minimum requirements for this position.
Yes, I understand and agree
Yes, I understand but disagree.
02
Please select how you meet the minimum qualifications.
At least two (2) years of experience determining eligibility for multiple programs AND a Bachelor's Degree or higher.
At least two (2) years of experience determining eligibility for multiple programs AND an Associate's Degree.
At least three (3) years of experience determining eligibility for multiple programs AND a High School Diploma or GED equivalent.
None of the above.
03
Please describe your experience as it relates to the job description for this position.
04
Please explain what way(s) you would be able to uniquely contribute to the team and our efforts.
05
How would others you work with describe who you are as a person and employee? In other words, what would they say you are known for or characterizes who you are?
Required Question
Agency
Adams County
Address
4430 S. Adams County Parkway, Suite C4000BBrighton, Colorado, 80601-8213
Website
http://www.adcogov.org/current-career-opportunities
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