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PROGRAM INTEGRITY SPECIALIST

  • 512009
  • PHOENIX
  • DEPT OF HEALTH SERVICES
  • Full-time

DEPT OF HEALTH SERVICES

COME WORK WITH US! The Arizona Department of Health Services promotes and protects the health of Arizona’s children and adults. Our mission is to promote, protect, and improve the health and wellness of individuals and communities in Arizona. We strive to set the standard for personal and community health through direct care, science, public policy, and leadership. ADHS promotes alternative work schedules, flexible hours. We have positions that can fit any stage in your career, from entry to senior level. We offer a robust benefit package, including the ADHS Student Loan Assistance Program, where eligible employees can receive up to $437.50 per month for their outstanding student loans. Come check us out and see how you can make a difference in the lives of all Arizonans.

Program Integrity Specialist

DEPARTMENT OF HEALTH SERVICES

Job Location:

Address:  150 N. 18th Avenue, Phoenix, AZ 85007

Posting Details:

Salary: $58,500 

Grade: 21

Job Summary:

A Career in Public Service Awaits You, Come Join our Office of Injury and Violence Prevention Team!

Your Talent, Our Mission: To promote, protect, and improve the health and wellness of individuals and communities in Arizona.

Why work for ADHS? A great benefit of working for the State of Arizona is a fantastic work/life balance. State employees enjoy challenging work, popular remote work options, comprehensive health and wellness benefits, and career growth opportunities.

What You'll Do:

This position is responsible for the assistance in coordination and decision-making related to WIC Local Agency Financial Management Evaluation (FMEs), WIC clinic and staff program compliance, FME policy direction and oversight, WIC complaint resolution, and investigations. Will assist in discussions with internal and external stakeholders to ensure programmatic issues are addressed and implemented appropriately and in accordance with required regulations.

The incumbent will assist the Financial Review Manager to implement the newly designed FME infrastructure and utilize continuous quality improvement (CQI) tools. This includes ensuring all standard work, metrics, local agency feedback, report development, and corrective action plans are managed. This person will assist with interfacing extensively with internal and external stakeholders and develop strong business relationships within the management team. This position will assist in the coordination of the day-to-day operations of the complaint call center and official case files in the complaint management application. This position will assist in the development and production of WIC PI clinic financial ad hoc reports and ensure accurate and timely financial reporting of data to USDA on monitoring and investigative activities.

Responds promptly to customer needs; takes a customer-centric approach to problem-solving; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments; manages difficult or emotional customer situations; fosters relationships. Focuses on solving conflict; maintaining confidentiality; listening to others without interrupting; keeping emotions under control; remaining open to others' ideas and trying new things.

Identifies opportunities for use of solutions to improve efficiency and reduce waste. Works within guidelines of established methods; obtain, clarify, and provides information within established parameters.

Prioritizes and plans work activities; sets goals and objectives; uses time efficiently; communicates activities and results as appropriate

Works with minimal guidance; regularly participates in reviews of assigned and completed tasks.

Job Duties:

-Under supervision, perform bi-annual WIC Financial Management Evaluations and Subrecipient Reviews of local agencies for WIC, BFPC, and AZ HealthZone Programs in accordance with Federal regulations and State policies and procedures regarding the following: Per 7CFR 246.19 state WIC agencies are required to have Financial Management Evaluation of each local agency at least once every two years.
-These reviews must include financial on-site reviews of our 21 agencies and Health Centers in Arizona. Travels throughout Arizona to complete the financial on-site reviews.
-Receives and tracks complaints received against WIC participants and staff where allegations have been made referencing Program Fraud and Abuse. The employee will research complaints through varied means (electronic database, oral communication, detailed written reports, and financial records).
-Create investigative cases based on the research results, maintains accurate records in the complaint application, and electronic case flies.
-Reviews and analyzes computer-generated reports and other data deemed necessary to identify WIC's unallowable expenses. Prepares complex recommendations/spreadsheets for potential investigations and/or audits deemed necessary. Monitors the status of investigations and tracks all financial reviews.
-Provides technical assistance to internal and external stakeholders on allowable and unallowable expenditures, coach teaching, and trains financial lead within agencies and health centers incoming callers on the complaint hotline in various areas including but not limited to program policies and procedures, food packages, food instrument cashing process, point of sale concerns, basic infant formula concerns,
-Provides technical assistance to state staff, local agencies, and others to ensure their correct interpretation of program regulations and Arizona WIC Policies and Procedures. Provide suggestions about policy and procedure revisions based on observed best practices.

Knowledge, Skills & Abilities (KSAs):

Knowledge of:
- Federal and state laws, rules, and regulations.
- Mentoring peers.
- Civil and criminal laws applicable in the State of Arizona, particularly State, Federal and local laws concerning fraud, misrepresentation, forgery, and theft; the methods, techniques, procedures, and practices of criminal investigations; court procedures, practices, rules, and traditions; effective methods and techniques of undercover law enforcement work and surveillance; techniques and methods of investigative courses.
- Accounting concepts as it relates to fraudulent business schemes.
- General liability, payroll, and other financial reports.
- Project management skills
- Leading team(s) to design solutions for clients.
- Performance Management (PM), Continuous Quality Improvement (CQI), and Lean methodologies.

Skill in:
- Oral and written communication
- Interpersonal relations, as applied to contacts with subordinate staff, managers and representative of other governmental agencies, community organizations, and the public.
- Analyzing and evaluating a variety of nutrition and health data to identify problems and make determinations regarding concepts, and practices of administration of the national, state, and local public health delivery systems; of human resources and financial management.
- Strong customer service skills.
- Basic methods, techniques, and practices of conducting investigations, examining, and evaluating evidence.
- Techniques of writing concise and comprehensive reports
- Methods, techniques, and practices of mediating and negotiating settlements.
- Meeting deadlines.
- Coordinating and implementing projects, project management, work scheduling, and the management of investigative caseloads.
- Advanced skills in computer software for word processing; and management of and participation in a cohesive team environment.

Ability to:
- Plan, organize and direct the work of others.
- Provide leadership in all phases of the administration of health programs and services.
- Work with a wide variety of individuals and different local, state, and federal organizations, to delegate and function both as a manager and as a team member.
- Balance, prioritize and organize multiple tasks.
- Work collaboratively in teams and across organizations. Build strong relationships inside and outside the organization
synthesize feedback and adjust plans accordingly.
- Develop and write technical documentation.
- Apply problem resolution techniques.
- Analyze facts and reach logical conclusions.
- Have a basic understanding of the State of Arizona Accounting Manual (SAAM).
-Support a diverse multi-cultural workforce that reflects the community, promotes equal opportunity at all levels of public employment, and creates an inclusive work environment that enables all individuals to perform to their fullest potential free from discrimination.

Selective Preference(s):

A Bachelor's degree in a related field or 4 years of work experience in bookkeeping/payroll/accounts payable may substitute. Strong analytical, skills, critical thinking, time management, and verbal and written communication skills. Well-developed interpersonal skills.

Pre-Employment Requirements:

Employees who drive on state business require possession of and the ability to retain a current, valid state-issued driver’s license appropriate to the assignment. Employees who drive on state business are subject to driver’s license checks, must maintain acceptable driving records, and must complete any driver training (See Arizona Administrative Code R2-10-207.11).

Benefits:

The State of Arizona provides an excellent comprehensive benefits package including:
− Affordable medical and dental insurance plans
− Paid vacation and sick time
− 10 paid holidays per year
− Wellness program and plans: Health Impact Program (HIP) where you can earn up to $200 annually by participating in our award-winning program of free preventative health screenings (mini-health, mammography, prostate), immunizations, lifestyle/mindfulness classes and physical activities) and Employee Assistance Program (EAP) Counseling sessions - 12 free per year per issue for each employee and each covered dependent. Available 24/7 for support, resources and information on work/life solutions, dependent/elder care, college planning, wills, legal guidance, financial resources, funeral planning and more)
− Life insurance
− Short/long-term disability insurance
− Defined retirement plan
− Award winning Infant at Work program
− Credit union membership
− Transit subsidy
− ADHS Student Assistance Pilot Program

For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Retirement:

To help you build a financially secure future, the State makes monthly contributions to finance your retirement benefit. The State will contribute to the ASRS in an amount equal to your contribution. In other words, you and the State will each pay 50% of the total cost of the benefit. New State employees have a 27-week wait period for contributions to begin.

Contact Us:

Arizona State Government is an EOE/ADA Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by calling (602) 542-1085. Requests should be made as early as possible to allow sufficient time to arrange the accommodation. DHS is an Equal Employment Opportunity Employer. All newly hired employees will be subject to E-Verify Employment Eligibility Verification.

ARIZONA MANAGEMENT SYSTEM (AMS)

All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress.  Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results.  
State employees are highly engaged, collaborative and embrace a culture of public service.

The State of Arizona is an Equal Employment Opportunity Employer.