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JOB REQUIREMENTS: This position is responsible for reviewing Medicaid related services within the Clinical and Family Services Division programs for the purpose of identifying client, staff and systems errors that may result in improper billings or inaccurate documentation. The Specialist also helps to train Division staff and Contracted providers to avoid Administrative Code errors, and to ensure general quality assurance and improvement activities occur over time. ESSENTIAL FUNCTIONS Maintains knowledge of Federal and State rules, regulations and Administrative Codes that impact Medicaid; trains staff to recognize and correct errors and ensure program compliance and accuracy. Performs Quality Assurance reviews on internal cases and contracted provider records for compliance with Federal and State statutes, Department policies and procedures, and Administrative Codes. Analyzes the results of reviews and works with Department staff on implementing corrective measures. Develops QA tools and reports to ensure compliance with program policy and procedures, Medicaid/Medicare requirements and State statutes. Assists with onsite and desk review program evaluations and state recertification visits; coordinates with the unit supervisor to create and implement plans of correction when necessary. Develops and maintains resources and training materials for use with internal staff and contracted partners; attends trainings to maintain current knowledge of all rules and regulations enacted by Federal, State and local entities relative to Medicaid/Medicare requirements. Provides onboarding, training, and ongoing support to contracted CCS providers to maintain statutory compliance. Ensures initial and annual training requirements are met as outlined in State statutes. Identifies and assists in developing Quality Improvement strategies for Department programs, and monitors results of implementation of those strategies. Ensures that a continuous improvement cycle process is maintained. Assists in monitoring quality of providers through quality improvement functions, contract performance standards, outcome measures, and consumer and department staff feedback. Annually administers client satisfaction surveys and compiles results. Facilitates meetings with leadership and staff on the analysis of performance, including identification of challenges, achievement, and compliance with established guidelines and best practice standards. Participates actively and effectively in activities such as conference calls and professional meetings to include fiscal-related Statewide and Regional meetings. Completes and maintains necessary documentation and reports according to applicable audit and statutory requirements, Codes, and policies. May be designated to speak to the community and other organizations to provide public education. Maintains regular and predictable attendance. Other duties as assigned. ***** OTHER EXPERIENCE AND QUALIFICATIONS: Experience working in an Electronic Health Record (EHR). Experience working in/with state certified programs and state and federal privacy guidelines and statutes. Previous work experience with Compliance or Quality Assurance in a Human Services environment. Must successfully pass caregiver and criminal background check. Must possess a valid driver\'s license. ***** APPLICATION INSTRUCTIONS: Apply Online: www.co.dodge.wi.gov/careers