Title: Quality Control Reviewer Roanoke-Piedmont Region, Compliance Division W0233 (Repost)
State Role Title: Community and Social Svc Specialists, All Other
Hiring Range: $55,000 - $65,000, commensurate with experience
Pay Band: 4
Agency: Department of Social Services
Location: PIEDMONT REGIONAL & LICENSING
Agency Website: dss.virginia.gov
Recruitment Type: General Public - G
Job Duties
At the Virginia Department of Social Services, we put people at the center of everything we do. We believe that every Virginian can live a life of dignity and that all voices, ideas and experiences contribute greatly to our pursuit of excellence. Inspired by continuous improvement, we commit ourselves to listening, learning and cultivating environments of trust, respect and positive engagement. Together, we are mission-driven, eager to achieve, and passionate about bringing the best of who we are to those we serve.
We design and deliver high-quality human services that help Virginians achieve safety, independence and overall well-being. We are a $2 billion agency – one of the largest in the Commonwealth of Virginia – partnering with 120 local departments of social services and 31 community action agencies, along with faith-based and non-profit organizations, to promote the well-being of children, adults, and families statewide. We proudly serve alongside 1,650 (state) and 12,200 (local) human services professionals throughout the Social Services System, who ensure that thousands of Virginia’s most vulnerable citizens have easy access to the services and benefits available to them.
In addition to a rewarding work experience, VDSS offers excellent health and life insurance benefits, pre-tax spending accounts, state funded Short- and Long-Term Disability, paid holidays, vacation, tuition assistance, free wellness programs, and a state retirement plan with options for tax-deferred retirement savings including employer matching – Employee Benefits.
About the Position:
The Quality Control Reviewer (QCR) for the Compliance Division conducts reviews of Local Department of Social Services (LDSS) cases in the Supplemental Nutrition Assistance Program (SNAP), Medicaid and other programs, as mandated or directed, to evaluate LDSS performance. Performance is measured by accuracy of expenditures, timeliness of benefit delivery, and compliance with federal mandates and state guidelines utilizing methodology that ensures program integrity and non-bias. The QCR identifies procedural misunderstandings by LDSS, describes performance trends, discrepancies in policy and refers questions of program abuse for fraud investigation. Review results provide a systematic method of measuring the validity of Virginia's performance in state and federally funded programs and assists with the development of program corrective action measures. As currently mandated by the United States Center for Medicare and Medicaid Services {CMS), reviews for Payment Error Rate Measurement {PERM) and Medicaid Eligibility Quality Control (MEQC) are alternated each fiscal year. The PERM and MEQC review findings are utilized by CMS and management in both VDSS and the Virginia Department of Medical Assistance Services (DMAS) in the statewide assessment of Medicaid program performance and appropriateness of expenditures. US Department of Agriculture (USDA) Food and Nutrition Service (FNS) utilizes QCR review findings to determine the SNAP error rate for Virginia which is compared to other state error rates. The work of Virginia's QC Reviewers is subject to re-review by USDA; approximately 50% of active case reviews, 40% of closed case reviews and 100% of case reviews that are not completed are re-reviewed. Errors in the QC Reviewer's work identified by USDA may cause the state error rate to increase because of the complex federal regression formula utilized by USDA. Therefore, an extraordinary level of programmatic knowledge as well as ability to thoroughly review and evaluate case records for accuracy is required for individuals in this position and will provide direct support to Benefit Programs in the way of data for programmatic corrective action and staff training.
Minimum Qualifications
Must have demonstrated:
• Ability to independently manage a deadline-oriented workload with a high degree of accuracy
• Proficiency in Quality Control review policies and procedures.
• Ability to interpret and apply complex state and federal regulations and procedures.
• Good working knowledge of eligibility requirements for the SNAP and Medicaid programs.
• Ability to demonstrate effective oral and written communication skills.
• Excellent investigatory and analytical skills.
• High level of interpersonal skills to elicit cooperation of diverse customer populations and interested third parties.
• Ability to work effectively with high-level professional staff from both the private and public sectors.
• A high degree of computer skills and a valid driver's license are essential.
• Knowledge of the Temporary Assistance for Needy Families (TANF) and Energy Assistance (EA) programs.
Additional Considerations
• Good working knowledge of SNAP/Medicaid eligibility programs; Quality Control experience is a plus.
Special Instructions
You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to “Your Application” in your account to check the status of your application for this position.
To be considered for this position, you must submit a Commonwealth of Virginia application or resume through the on-line “Virginia Jobs” (RMS) employment site no later than 11:55 p.m. on the closing date listed. Each application is reviewed for documentation that shows the applicant meets the minimum and preferred qualifications stated in the job announcement. The decision to interview an applicant is based on the information provided. This website will provide a confirmation of receipt when the application is submitted for consideration. Please refer to your RMS account for the status of your application and this position.
Selected candidate(s) must successfully pass a fingerprint-based criminal history background check. A record of criminal history does not automatically bar an applicant from consideration. Employment verification will be conducted to include current/previous supervisory employment reference checks.
VDSS will record information from each new employee’s Form I-9 (Employment Eligibility Verification) into the Federal E-Verify system to confirm identity and work authorization.
Selected candidate may be required to assist the agency or state government generally in the event of an emergency declaration by the Governor.
This position may be eligible for telework opportunities; availability, hours, and duration will be in accordance with the Commonwealth’s Teleworking policy on a case-by-case basis.
Occasional in-state, overnight travel may be required. Selected candidate(s) may be required to use their personal vehicle or state vehicle as available for business use.
VDSS values the service and experience of our Veterans. As such, Veterans are encouraged to apply and receive preference in the hiring process. AmeriCorps, Peace Corps and other national service alumni also are encouraged to apply.
Reasonable accommodations are available to applicants, if requested, during the application and/or interview process.
Virginia Department of Social Services does not provide sponsorship.
The Virginia Department of Social Services is an Equal Opportunity Employer and encourages diversity within its workforce.
We are a “Virginia Values Veterans” (V3) official certified company and state agency that provides hiring preference to Veterans and Members of the Virginia National Guard in support of Executive Order 29, (2010). If you are a Veteran or Virginia National Guard
Member, we urge you to respond accordingly on your state application or resume. Minorities, Individuals with disabilities, Veterans and people with National Service experience are encouraged to apply.
For more information about our employment practices, please visit our “Vision, Mission and Strategic Plan”. Multiple positions may be filled from this recruitment within 90 days of the closing date.
Contact Information
Name: VDSS – Division of Human Resources
Phone: dssrecruitment@dss.virginia.gov
Email: dssrecruitment@dss.virginia.gov
In support of the Commonwealth’s commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly COD) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their AHP Letter. Requesting an AHP Letter can be found at AHP Letter or by calling DARS at 800-552-5019.
Note Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1, 2022- February 29, 2024, can still use that COD as applicable documentation for the Alternative Hiring Process.
The Commonwealth of Virginia is located in the South Atlantic region of the United States. It was the 10th state to be admitted to the Union on June 25, 1788. Home to approximately 8 million residents, Virginia is the 12th most populous state in the United States. The capital is Richmond, and its most populous city is Virginia Beach.
The narrative history of the Commonwealth of Virginia often begins with the founding of Jamestown in 1607, near what is now modern day Williamsburg, Virginia. Jamestown became the first permanent English settlement in the New World, and the Virginia General Assembly, established on July 30, 1619, is now recognized as the oldest legislative body in the western hemisphere. When Virginia became a royal colony in 1624, the robust tobacco trade that had been developing in Virginia helped establish the American colonies as a powerful economic force. During the American Revolution, Virginia witnessed the final surrender of British forces at Yorktown and later became known as the birthplace of many revolution-era figures and future American presidents, including George Washington and Thomas Jefferson. To date, 8 United States presidents have been born in Virginia, more than in any other state.
The modern government of Virginia is nearly identical in structure to the federal government, and is divided into 3 branches, these being the executive, legislative, and judiciary branches. The Virginia General Assembly is comprised of the 100-member House of Delegates and the 40-member Senate. A governor and lieutenant governor are elected every 4 years. Governors cannot be elected to or serve consecutive terms. Virginia’s judicial system consists of the Supreme Court of Virginia and the Court of Appeals of Virginia, the Circuit Courts, and the lower General District Courts and the Juvenile and Domestic Relations District Courts. Virginia has 13 electoral votes in presidential elections, and possesses 11 seats in the U.S. House of Representatives.
