N.C. Department of Information Technology · 5 hours ago
Quality Assurance Analyst
Wake County, NC
Full-time
Onsite
Entry Level
$24/hr - $28/hr
1+ years expThe N.C. Department of Information Technology is part of the North Carolina State Government, which aims to enhance public services across the state. The Quality Assurance Analyst will be responsible for conducting reviews of Medicaid recipient eligibility determinations to ensure compliance with policies and accuracy in decisions, while also preparing reports and providing training to county staff.
Information Technology & Services
Responsibilities
Conduct statewide reviews of Medicaid cases for accuracy and timeliness of eligibility determinations
Perform statewide reviews of Medicaid cases for application of eligibility policies and procedures in the approval, denial, and termination of benefits
Following State policy regulations for quality control reviews, systematically review and evaluate samples of cases, and accurately document review findings
Collaborate with county staff on a monthly basis to report case review findings
Provide support to county staff in implementing internal control procedures to mitigate error risk and recurrence
Analyze Medicaid policy to enhance knowledge needed to conduct accurate case reviews
Qualification
Required
Bachelor's degree from appropriately accredited institution and one year of experience related to the area of assignment; or an equivalent combination of training and experience
Preferred
Prior experience as an eligibility caseworker or investigator
Ability to interpret and apply rules, regulations, standards, and policies regarding Medicaid eligibility
Extensive knowledge of NCFAST eligibility system and NC TRACKS (MMIS) system
Experience with conducting reviews of Medicaid eligibility
Benefits
Health insurance coverage under the High-Deductible Health Plan (HDHP)
Company
N.C. Department of Information Technology
The N.C.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Torre Jessup
Chief Operating Officer
Alysa Kelly
Executive Assistant to Chief Deputy/CIO/Chief Privacy Officer/Director of Enterprise Operations
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