Job Description:

GENERAL STATEMENT OF DUTIES: To be responsible for the planning, organization, and operation of a complex governmental accounting and budgetary system within a human service agency; to supervise and conduct large and complex financial audits of the records and accounts of municipalities and non-profit community organizations, including nursing homes; to assist in providing various business management functions for a human services agency such as purchasing, storekeeping, and budget preparation; and to do related work as required.
SUPERVISION RECEIVED: Works under the general supervision of a superior with considerable latitude for the exercise of independent judgement and initiative; objectives and policies are determined in consultation with a superior or reviewed by the superior on their inception; work is appraised by results accomplished and is usually completed independently.
SUPERVISION EXERCISED: Plans, assigns, organizes, supervises, and reviews the work of professional staff and clerical subordinates; reviews work in process and upon completion for accuracy and compliance with prescribed procedures and directives.


To be responsible for the planning, organization, and operation of a complex governmental accounting and budgetary system within a human service agency.

To be responsible for fiscal/financial management functions within a division of a human services agency; to control expenditures and provide budgetary and cost control expertise; to perform specialized and technical budgetary and accounting functions.

To be responsible for assisting a superior in the preparation and presentation of a divisional and/or departmental budget request for a human services agency.

To review contracts proposed by a human services agency to insure accuracy and appropriateness to state and/or federal regulations.

To assist a superior in the formulation of policies, plans and objectives connected with the administration of the business management services of a division within a human services agency.

To supervise and conduct large and complex field audits of the records and accounts of nursing homes subject to state regulation, of private non-profit community organizations or of municipalities.

To assist program staff in analyzing federal regulations and guidelines pertaining to disadvantaged persons and contracting federal funds to organizations to accomplish similar objectives.

To prepare and direct the preparation of various monthly, quarterly, semi-annual, and annual reports and financial statements required by various units of state government and by the federal Departments of Agriculture, Education, and, Health and Human Services to insure the efficiency and economy of the business management services within a human service agency.

To plan, organize, supervise and direct the work of a professional staff and clerical subordinates engaged in fiscal/financial management operations.

To do related work as required.

KNOWLEDGES, SKILLS AND CAPACITIES: A thorough knowledge of the principles and practices of accounting; a working knowledge of the principles of corporate and governmental finance; a working knowledge of the principles and techniques of budgeting; a working knowledge of federal guidelines for utilizing federal grant monies; the ability to analyze and interpret accounting systems and procedures; the ability to prepare audit reports and financial statements, including federal financial status reports; the ability to plan, organize, supervise and direct the work of subordinates engaged in professional auditing, accounting, or other fiscal management operations; and related capacities and abilities.


Education: Such as may have been gained through: graduation from a college of recognized standing with specialization in Accounting or Business Administration; and
Experience: Such as may have been gained through: employment in a responsible position in a public agency or in private industry involving advanced professional accounting and/or advanced professional auditing work.
Or, any combination of education and experience that shall be substantially equivalent to the above education and experience.


Working within the EOHHS Medicaid Program Integrity team, responsible for administrative functions to support the operation of the unit including but not limited to:Federal and State required regular interval program evaluations – Eligibility, Enrollment, Claims and Provider
  • Annual Medicaid certification standards / provider enrollment review.
  • Assist with Program Integrity investigations and perform other program integrity reviews as needed as defined in
  • Collection and recording of tips, referrals, recoupments, and investigative status/decisions.
  • Administrative and coordinated support to the fee-for-service, surveillance, and utilization review (SUR), Managed Care (MCO) and other brokers investigative units as needed.
  • Coordination of submission/response on behalf of the Medicaid program to all required eligibility, managed care enrollment, provider enrollment and claims payment evaluations required Federally or statutorily.
  • Coordination with Medicaid policy staff to ensure establishment of clear policies for the purposes of straightforward program assessment.
  • Define procedures and maintain documentation for successful, streamlined evaluation submissions.
  • Response and coordinated corrective action, as needed, inter and intra-agency.
  • Education and guidance to the Medicaid provider community, including MCOs and Brokers in advance of reviews or due to review findings.
  • The preferred candidate should demonstrate their ability to establish solid working relationships with all Program Integrity partners including but not limited to the Attorney General’s Medicaid Fraud Unit and the Office of the Inspector General.

Resume and Cover Letter Preferred. 
Preferred skills:
  • Excellent written and verbal communication skills are preferred. 
  • Ability to present to leadership and stakeholders are also preferred.
  • Organizational skills, with an ability to multi-task and prioritize effectively under deadlines
  • Knowledge of Medicaid claims, eligibility, and enrollment policies in addition to the policies that support the Medicaid Program Integrity core functions.


Job ID: 8075657395270415162

RI, RI, Rhode Island Jobs

02908 Jobs

Social and Human Service Assistants Jobs











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