Program Integrity Investigator-162010,162126

Program Integrity Investigator-162010,162126 Adams County - 3.8 Commerce City, CO Job Details Full-time $61,805.39 - $89,617.82 a year 1 day ago Qualifications Research High school diploma or GED Home visits (communication methods) Full Job Description JOB This position is designed for an experienced Community Support Case Manager who is highly skilled in the accurate and timely issuance of all programmatic benefits. Investigators work in both an independent and team-oriented atmosphere while utilizing strong behavioral, analytical, communication, and customer service skills to investigate allegations of possible program eligibility abuse and fraud, apply findings to public assistance cases, and determine intentional program violations. They will provide clear and concise reports documenting findings coupled with the communication skills necessary to testify in Adams County Administrative Hearings and Civil Court. Investigators are expected to remain highly proficient with all current and future program policy requirements, as well as in the use of analysis tools, including Microsoft Excel, Access, and other databases, and computer systems.

EXAMPLE OF DUTIES

Conduct thorough and professional investigations into concerns of program violations and fraud, including extensive research in multiple databases, client interviews, phone calls, and home visits to obtain needed verification and evidence.

Communicate with various entities and individuals such as customers, landlords, employers, lawyers, human service workers, and schools to obtain sufficient and accurate evidence and verification.

Write clear and concise reports of investigations completed.

Clearly communicate relevant program rules to households in verbal and written form.

Keep organized digital files of reports, findings, and evidence.

Apply program rules to the information discovered to determine if/when the information should have been made known to the County and should have affected the household's benefits.

Utilize information gleaned from investigations to complete a thorough review of the household's eligibility status, decide if a household received benefits it was not eligible to receive, determine if an intentional program violation (IPV) is warranted, and decide if civil action is appropriate.

Complete data entry in the Colorado Benefits Management System to apply investigative findings to each case and ensure correct, effective timeframes and outcomes, including any resulting overpayments, and establish claims in accordance with program rules and guidelines.

Ensure all actions taken are properly documented in the Colorado Benefits Management System.

Prepare evidence, attend and testify in state level hearings on applicant/participant appeals and county conferences.

Complete and send required documentation to communicate claim information to liable individuals timely in accordance with program regulations.

Provide coverage for other functions of the Program Integrity unit as needed including work assigned to the recovery specialists and administrative assistant.

SUPPLEMENTAL INFORMATION

Experience:

At least two (2) years of experience determining eligibility for multiple programs is requiredExperience as a Community Support Case Manager II/III with consistently high case productivity and accuracy rates is preferred.

Working experience and knowledge of all programs - Adult Financial, Colorado Works, Food Assistance, Medical Assistance, LTC is preferred but not required.

There is an expectation to learn all programs once hired.

Education and Training:

High school diploma or GED equivalent required.

Additional analytical, statistical, or other related higher education is preferred.

Bilingual in English/Spanish is preferred.

License or Certificate:

None.

Background Check:

Must pass a criminal background check.

Other:

Ability to work in a standard office environment.

Ability to utilize personal vehicle or other mode of transportation to conduct field investigations as needed.

Ability to obtain, maintain, and ensure continued access to State and County systems in strict compliance with all applicable county and state regulations, policies, and user agreements.