Supervising Eligibility Technician

Supervising Eligibility Technician

This position will be known as the Program Integrity Review Specialist and report to the Program Integrity Unit.

Conducts case reviews across all DHS Programs using a variety of review tools and processes.

Conducts both pre-authorizations and post-authorization case reviews based on established review requirements and priorities.

Reviews cases across programs, including Supplemental Nutritional Assistance Program, Medicaid, Child Care Assistance Program, Rhode Island Works Program, and other DHS Programs as assigned.

Identifies case processing errors, trends, and opportunities for improvement through review of case record, eligibility determination, and supporting information.

Applies program knowledge, policy and procedural knowledge and review standards to evaluate the accuracy and quality of case actions and eligibility determinations.

Documents review findings accurately and timely; to support data analysis, corrective action, and program improvement.

Provides feedback on case findings and recurring issues to support the Program Integrity feedback loop.

Participates in quality control, quality assurance, state and federal review activities as assigned.

Remains flexible in assignments and develops proficiency with multiple review tools, programs, and review methods.

Collaborates to develop materials and field guidance related to error trends.