Public Benefits Quality Control Analyst

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

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.