Contract Administration coordinates and monitors contract-related activities for all divisions of the Department of Health and Human Services. It serves as fiscal liaison between Department of Health and Human Services (DHHS) and purchase and professional services contractors.
Job Summary: Under general direction, the Quality Specialist will assist the Department of Health and Human Services (DHHS), Contract Administration, in carrying out fundamental quality and monitoring activities. This position includes ensuring program compliance of agencies to eligible recipients in DHHS; to strengthen accountability and ensure compliance with applicable laws, rules and regulations.
Receive, monitor, and review contract agency requests as well as caregiver background checks.
Conduct periodic provider and contract agency visits/reviews to determine contractual and program compliance. Document results of agency review to include written reports and corrective plans.
Assist in tracking and assessing contract performance and outcome measures
Compile, analyze, and summarize review data; review and evaluate program accomplishments or other program outcome measurement data; summarize review findings, draft and issue review reports; recommend corrective actions and monitor payment and status of fiscal recoveries.
Provide technical assistance to DHHS providers on compliance with state, federal, and county ordinances and resolutions, P&P’s, and other administrative regulations. Inform agencies on resources and tools available to assist in contractual, fiscal, and program compliance.
Assist Quality Assurance Coordinator with internal operational process evaluations, division program reviews, and special impromptu investigations as well as in other quality and contract compliance activities as assigned.
Make recommendations to providers on findings, issues, and problem resolution. Assist providers in developing corrective action plans.
Assist divisions with conducting investigations, documenting findings, and results, as well as resolving complaints.
Participate in committees and workgroups as applicable.
Travel, up to 30% of work time, to agency site visits as well as offsite meetings.
Perform all other duties as assigned.
Must be a current resident of the State of Wisconsin
Current Wisconsin Driver's License and access to a reliable insured vehicle; both maintained throughout employment
A Bachelor’s Degree or higher from an accredited college or university is required. A major in a health or human services related field (e.g., Social Work, Psychology, Criminal Justice), public policy, public administration, or business administration is highly preferred.
At least three (3) years of recent related experience working in a Human Services or Quality Assurance role. E.g. monitoring health or social service contracts, auditing, or project management of a governmental, nonprofit health, or social service program.
Possess at least a basic level of experience with Microsoft Office programs to include Excel, Word, Power Point, Outlook
Able to travel to provider sites up to 30% of the time
Knowledge, Skills, and Abilities: Highly motivated team player with strong analytical skills and attention to detail. Needs to be flexible and quickly adapt to changing priorities and deadlines. Effective written and verbal communication skills; ability to manage time and work independently; ability to prioritize and multitask; ability to analyze, evaluate and solve problems; ability to verify, document and communicate audit/review results. Knowledge of quality assurance/quality improvement procedures, best practices, research skills, public policy, public administration, or business administration is preferred.