STATE OF NEW HAMPSHIRE
HUMAN RESOURCES
CLASSIFICATION: QUALITY CONTROL REVIEWER
Class Code: 7405-20
Date Established: 09-12-66
Occupational Code: 7-7-7
Date of Last Revision: 11-08-06
BASIC PURPOSE: To investigate and review public and
provider programs to ensure compliance with program standards and to make
recommendations for improvements or changes in program procedures.
CHARACTERISTIC DUTIES AND RESPONSIBILITIES:
·
Interviews providers
or recipients for the purpose of verifying information found in case records.
·
Participates in the
development and maintenance of a system of reviews utilizing regulatory agency
standards, objectives and goals as evaluation tools.
·
Conducts detailed
review and analysis of randomly selected clientele and audits payment cases,
including open and closed records.
·
Reviews federal and
state regulations and policies and applies them to cases being reviewed.
·
Prepares reports of
program activities for review by supervisors and federal officials.
·
Conducts
investigations through state agencies, employers and various financial and
insurance agencies to verify any other information relevant to a particular
case's eligibility history.
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DISTINGUISHING FACTORS:
Skill: Requires skill in developing formats
and procedures for special applications OR in investigating and reviewing the
use of equipment and data for a specialized function.
Knowledge: Requires logical or scientific
understanding to analyze problems of a specialized or professional nature in a
particular field.
Impact: Requires responsibility for
contributing to immediate, ongoing agency objectives by facilitating the direct
provision of services to the public or other state agencies. Errors at this level result in
inaccurate reports or invalid test results and require significant investment
of time and resources to detect.
Supervision: Requires direct supervision of other
employees doing work which is related or similar to the supervisor, including
scheduling work, recommending leave, reviewing work for accuracy, performance
appraisal, or interviewing applicants for position vacancies.
Working Conditions: Requires performing regular job
functions in a controlled environment with minimal exposure to disagreeable job
elements and little risk of hazard to physical or mental health.
Physical Demands: Requires light work, including
continuous walking or operating simple equipment for extended periods of time
as well as occasional strenuous activities such as reaching or bending.
Communication: Requires summarizing data, preparing
reports and making recommendations based on findings which contribute to
solving problems and achieving work objectives. This level also requires presenting information for use by
administrative-level managers in making decisions.
Complexity: Requires coordinating a combination of
diverse job functions in order to integrate professional and technical agency
goals. This level also requires
considerable judgment to implement a sequence of operations or actions.
Independent Action: Requires a range of choice in applying
a number of technical or administrative policies under general direction and in
making routine decisions or in recommending modifications in work procedures
for approval by supervisor.
MINIMUM QUALIFICATIONS:
Education: Bachelor's degree from a recognized
college or university with a major study in one of the liberal arts or a field
related to business administration.
Each additional year of approved formal education may be substituted for
one year of required work experience.
Experience: Three years' experience at a level
equivalent to a Family Service Specialist or Case Technician, with
responsibility for review of operations, conducting investigations, program
auditing, or quality control. Each
additional year of approved work experience may be substituted for one year of
required formal education.
License/Certification: Eligibility for New Hampshire driver's
license.
SPECIAL REQUIREMENTS:
For appointment
consideration, Quality Control Investigator applicants must successfully
participate in a structured interview measuring possession of knowledge, skills
and abilities identified as necessary for satisfactory job performance by this
class specification. The
structured interview is developed and administered, according to Division of
Personnel guidelines, by representatives of the state agency in which the
vacancy exists.
RECOMMENDED WORK TRAITS: Extensive knowledge of the
administration, operation, methods and materials relating to the program to
which assigned. Considerable
knowledge of investigative techniques.
Working knowledge of planning and procedures necessary for specific
program operations. Ability to
plan and organize work activities and to determine materials, space, equipment
and personnel necessary to accomplish goals and objectives. Ability to work with and secure the
cooperation of others. Ability to
communicate effectively. Ability
to establish and maintain effective working relationships with program
administrators, public officials and clientele. Must be willing to maintain appearance appropriate to
assigned duties and responsibilities as determined by the agency appointing
authority.
DISCLAIMER STATEMENT: This class specification is descriptive
of general duties and is not intended to list every specific function of this
class title.
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Last Updated 10/21/04
URL: /hr/classspec_q/7405.htm