Quality Assurance Analyst

North Carolina Department of Health and Human Services (DHHS)

Wake County, NC, United States
$24.00 to $28.00 ph; benefits: health insurance co...
Medicaid eligibility determinations
Policy compliance reviews
Corrective action activities
This position is responsible for conducting reviews of Medicaid recipient eligibility determinations in local Departments of Social Services

Job Summary

  • This position is responsible for conducting reviews of Medicaid recipient eligibility determinations in local Departments of Social Services.
  • The purpose is to ensure determinations made for Medicaid programs are accurate and in compliance with policy while identifying instances of error for resolutions.
  • This is a temporary position and there are no leave or retirement benefits offered with this position.

Matching Summary

This position is responsible for conducting reviews of Medicaid recipient eligibility determinations in local Departments of Social Services.

Salary

$24.00 to $28.00 per hour; Benefits: Health insurance coverage under HDHP may be available; Other: No leave or retirement benefits

Skills & Requirements

Must-have

  • Medicaid eligibility determinations
  • Policy compliance reviews
  • Corrective action activities
  • Written reports on findings
  • Presenting training to counties

Nice-to-have

  • Eligibility caseworker experience
  • NCFAST eligibility system knowledge
  • NC TRACKS (MMIS) system knowledge
  • Risk mitigation strategies

Key Requirements

  • Bachelor's degree or equivalent combination of training and experience
  • One year of related experience
  • Prior experience as an eligibility caseworker or investigator preferred
  • Ability to interpret and apply Medicaid eligibility rules

Work Rights

Not specified

Tailored Resume

Cover Letter