DHHS Quality Control Specialist

Nebraska Department of Health and Human Services; Nebraska; On-site; USD 22,743,000 - 32,391,000; Full time

Job summary

The Nebraska Department of Health and Human Services, Office of Economic Assistance, is seeking a Quality Control Specialist to conduct quality reviews of Medicaid and Child Support programs. The role emphasizes accuracy, policy interpretation, and strong communication with internal staff.

Ideal candidates will have a bachelor’s degree in business/human services and knowledge of public assistance eligibility, with preference for Child Support experience.

Qualifications

• Bachelor's degree in business, human services, or related field plus two years of experience determining or reviewing public assistance eligibility; OR six years of relevant experience.
• Preferred: Child Support Enforcement experience and knowledge of program policies.

Responsibilities

• Conduct QC reviews of Medicaid and Child Support programs to ensure compliance with federal and state regulations.
• Audit a statistically valid sample of cases by reviewing eligibility, payment accuracy, client responsibility, and agency actions.
• Perform field investigations, including in-home interviews, NFOCUS research, and third-party contacts to verify case information.
• Analyze and resolve conflicting or incomplete information and determine appropriate sources of verification.
• Evaluate agency determinations and identify over or under payments; classify and code errors.
• Communicate error findings professionally to the agency; recommend corrective actions.
• Monitor error trends and identify systemic issues related to policy, procedures, or automation.
• Present quality control results, data analysis, and recommendations to stakeholders.
• Mentor and support colleagues by sharing expertise and assisting with training.

Skills

Oral communication

Written communication

Attention to detail

Analytical thinking

Time management

Education

Bachelor's degree in business, human services, or related field

Tools

Eligibility systems

Data tracking tools

Job description

Job Posting

JR2026-00029324 DHHS Quality Control Specialist (Open)

The work we do matters!

Hiring Agency

Health & Human Services - Agency 25

Location:

Statewide, NE

Hiring Rate

$20.011

Applications No Longer Accepted On

09-28-2026

Job Description

The Department of Health and Human Services (DHHS), Office of Economic Assistance, is seeking a highly motivated individual with keen attention to detail to join our Team in the DHHS Quality Control (QC) Specialist role. The successful candidate should possess good oral and written communications skills.

Child Support experience is a significant need for this position, and candidates with this experience in place will be best positioned for success in the role.

Examples of Work

• Conduct quality control reviews of Medicaid, Child Support public assistance programs to ensure compliance with federal and state regulations.
• Audit a statistically valid sample of cases by reviewing eligibility, payment accuracy, client responsibility, and agency actions.
• Perform field investigations, including in-home interviews, NFOCUS research, and third-party contacts to verify case information.
• Analyze and resolve conflicting or incomplete information and determine appropriate sources of verification.
• Evaluate agency determinations and identify over or under payments; classify and code errors according to federal reporting standards.
• Communicate error findings professionally to the agency; recommend corrective actions.
• Monitor error trends and identify systemic issues related to policy, procedures, or automation.
• Stay current on changes to federal and state regulations, policies, and waivers and apply them accurately to reviews.
• Present quality control results, data analysis, and recommendations to internal and external stakeholders.
• Mentor and support colleagues by sharing expertise, reviewing work, and assisting with training and development efforts.
• Manage workload independently, prioritize assignments, and meet established deadlines while maintaining accuracy.

Hiring Rate: $20.011 per hour – non-exempt

Work Schedule: Monday – Friday; 8:00 AM – 5:00 PM

Dress Attire: Business Casual

Location: Statewide pending space availability

Driving is Required

Requirements / Qualifications

Minimum Qualifications: Bachelor’s degree in business, human services, or a related field, plus two years of experience determining or reviewing public assistance eligibility; OR six years of relevant experience. Any equivalent combination of education and experience will be considered.

Preferred Qualifications: Must have Child Support Enforcement experience

• Strong working knowledge of program-policy and eligibility requirements (specifically in Child Support programs and applications)
• Prior experience in eligibility determination, case management, or quality assurance
• Ability to analyze complex cases, accurately interpret policy, and identify errors
• High attention to detail with strong organizational and time-management skills
• Effective written and verbal communication skills for documenting findings and collaborating with staff
• Experience using eligibility systems, data tracking tools, and QC or federal/state reporting processes
• Ability to work independently, maintain confidentiality, and apply policy objectively and consistently
• Adaptability to policy changes and evolving program requirements

Other: Valid driver's license or able to provide independent authorized transportation.

Knowledge, Skills, And Abilities

Knowledge of: researching and interpreting public assistance policies and regulations, public assistance eligibility processes, and related computer systems, along with a general knowledge of compliance, audit functions, and data research principles.

Ability to: learn and apply state and federal laws, regulations, and procedures necessary to conduct quality control reviews, as well as an understanding of the role of quality control in public welfare agencies and welfare administration. Incumbents must be able to conduct on-site interviews with applicants, recipients, and public or private sources to obtain information; apply rules and regulations to the verification, determination, and documentation of reviews; utilize computer output information to complete accurate findings; gather, verify, and analyze eligibility and financial data; operate a personal computer and general office equipment, including spreadsheets, word processing, databases, email, internet, and other programs; perform basic math calculations; work independently with minimal supervision; and successfully complete assigned workloads within established deadlines.

Skill in: oral and written communication skills; establishing and maintaining effective working relationships with staff and the general public

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Benefits

We offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.

Check out all that the State of Nebraska has to offer! Benefit eligibility may vary by position, agency and employment status. For more information on benefits, please visit: https://statejobs.nebraska.gov/index.html#benefits

Equal Opportunity Statement

The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.