Compliance Specialist

Job Synopsis

This position is located in the Depa1tment of Human Service (DHS), Office of Program Review, Monitoring and Investigation (OPRMI), Quality Control Division (QCD). The Quality Control Division conducts state-level quality assurance reviews to determine payment accuracy and program outcomes for that Supplemental Nutrition Assistance Program (SNAP) and Medicaid program outcomes for the Supplemental Nutrition Assistance Program (SNAP) and Medicaid programs. The primary function of the QCD is to conduct investigations of a statistically reliable sample of SNAP cases and a random sample of Medicaid cases, report suspected fraud to the Fraud Investigations Division and gather enough statistical data to make eligibility and payment accuracy determinations for the sampled SNAP population and to gather enough data to determine if the Medicaid program is functioning as it was intended to function. Incumbent participates in performing a variety of investigative and analytical duties.

About DHS

It is the mission of DHS to empower every District resident to reach their full potential by providing meaningful connections to work opportunities, economic assistance, and supportive services. Our approach to preventing homelessness and supporting individuals and/or families experiencing homelessness is focused both on systems-level reforms and on the quality of the programs and supports within that system. These efforts include creating economic opportunity, making our neighborhoods safer, and providing more effective and efficient government services. This job announcement may be used to fill any future vacancies throughout the DC Government, Department of Human Services (DHS).

Duties and Responsibilities

Conducts the investigation/review of cases, which include contacting public and private agencies to obtain facts and signed statements, studies the background of the case, sequence of events and other case related information. Plans and coordinates the quality control program reviews. Establishes priorities for completing assignments and prepares and maintains schedules to ensure timely completion of assignments within supervisory established deadlines.

Determines by preliminary review and analysis, the appropriate methodology required to conduct the quality control review including the interview, securing information and verifying the validity of the information gathered. Testifies at administrative reviews, formal hearings, appeals and court trials on any portion of the examination/investigation conducted. Reviews and analyzes the records of the Department and non-Departmental agencies to determine client benefit eligibility and payment validity by applying the appropriate program policy and analyzing information provided by other agencies/private employers or third-party verifications.

Qualifications and Education

Specialized Experience: Specialized experience is experience that equipped the applicant with the particular knowledge, skills, and abilities to successfully perform the duties of the position, and that is typically in or related to the position to be filled. To be creditable, one (1) year of specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression.

License and Certifications

None.

Working Conditions /Environment

The work environment includes an office setting as well as an external field situation. The field setting can be extremely stressful, and knowledge of basic self-defense is recommended since travel includes visits to the recipient and others who may reside in high crime neighborhoods. The incumbent must be capable of recognizing dangerous situations and resourceful enough to avoid such situations.

Other Significant Facts

Tour of Duty: Monday – Friday; 8:30am – 5:00pm

Pay Plan, Series and Grade: CS-1801-11

Promotional Potential: None

Collective Bargaining Unit: This position is in a collective bargaining unit represented by AFSCME 2401 and union dues may be collected.

Position Designation: This position has been designated as Security Sensitive therefore the incumbent of this position will be subject to enhanced suitability screening pursuant to Chapter 4 of DC Personnel Regulations, Suitability and as such, incumbents of this position shall be subject to criminal background checks, background investigations, and mandatory drug and alcohol testing, as applicable.

Emergency Designation: This position has been designated as Emergency. Employees occupying positions designated as Emergency are required to:

• Provide advice, recommendations, and/or specific functional support necessary for the continuity of operations during a declared emergency.
• Remain at their duty station, or alternate work location (approved by their supervisor), if activated, when a situation or condition occurs and results in early dismissal for nonessential/non-emergency employees.
• Report to their duty station, when activated, on time and as scheduled when a situation or condition occurs during non-work hours, and results in the late arrival or closing of District government offices for non-essential/non-emergency employees.
• Telework during a declared emergency, instead of remaining or reporting to his or her duty station, if directed by the agency head (or designee), supervisor or manager.

EEO Statement: The District of Columbia Government is an Equal Opportunity Employer. All qualified candidates will receive consideration without regard to race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, physical handicap, or political affiliation.