Program Compliance Auditor

ARIZONA DEPARTMENT OF HEALTH SERVICES

150 N. 18th Ave, Phoenix, AZ 85007

“ Promoting Health and Wellness for all Arizonans” is the motto of the Arizona Department of Health Services (ADHS). ADHS promotes and protects the health of Arizona’s children and adults and sets the standard for personal and community health through direct care, science, public policy and leadership. ADHS is an award winning, nationally recognized department and is one of the largest in Arizona State Government with a budget of 1.5 billion dollars and workforce of approximately 1600 employees.

Visit our website at http://www.azdhs.gov

Program Compliance Auditor II

Program Integrity Team/Nutrition Services

Open until filled

JOB SUMMARY

This position, under limited supervision, functions as an auditing/compliance investigator which audits/investigates retail food stores (vendors) to make proper recommendation reports regarding any program integrity-related issues/concerns. The employee also works with State, Local Agency WIC and Nutrition Staff and all other professionals, as needed in a variety of related projects.

Responsibilities include:
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Conducting investigations, Vendor Site Reviews and inventory audits (when appropriate) of WIC retail food vendors; preparing investigation and inventory audit reports; preparing cost summaries for management of work performed by outside professional service contractors.
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Auditing invoices to determine if WIC reimbursement payments were appropriate; preparing notices and correspondences to vendors relating to program performance and non-compliance with the Federal and State Regulations; recommending the appropriate sanction schedule and preparing notification to Vendors of any adverse actions deemed necessary.
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Creating/preparing requests/trackers for undercover compliance buys to be completed by outside professional service contractor(s); receives completed compliances buy report forms and reviewing and evaluating work performed, as well as reviewing VSR (Vendor Site Review) forms to determine compliance with federally mandated minimum stock requirements.
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Preparing notice to contractor(s) regarding unacceptable performance on both compliance buys and VSR’S and determines whether non-payment is necessary; performing classroom/field training and developing training agendas and manual(s) for annual compliance contractor training.
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Utilizing specialized global information system mapping software (ArcGIS) to determine whether is adequate participant access to other WIC authorized Vendors, as well as using software to create detailed maps, which incorporate criteria established by Federal Regulations; utilizing same mapping process for analysis of WIC Program participant access to evaluate and compile data for notification of vendor closures near specific Local Agencies.
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Reviewing and analyzing computer generated reports and other data deemed necessary to identify WIC retail vendors who are at a high risk of committing fraud and abuse of the WIC Program; preparing complex recommendations/spreadsheets for potential investigations and/or audits deemed necessary.
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Monitoring status of investigations and sanction actions and monitoring collection of claims/complaints against WIC Vendors; managing day-to-day operations of overseeing the outside service contractors; projecting investigative time line to ensure federally mandated requirements are met.
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Receiving and tracking complaints received against WIC Vendors where allegations have been made referencing Program Fraud and Abuse; researching independent complaint investigations through varied means (electronic data base, oral communication, detailed written reports and financial records); creating investigative cases based on the research results, maintain an investigative tracking system, and case files.
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Conferring/networking with State Office of Attorney General Counsel and Federal, State and Local Law Enforcement agencies on WIC Cases; preparing case file for administrative, criminal and civil actions; attending and testifying as an expert witness at administrative hearing in both Federal, State and Local Courts (when necessary).
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Reviewing Arizona tax documents and other spreadsheets as part of the final analysis of Vendor redemptions to establish whether the Avobe-50%-Vendor (A50) determination has been performed adequately; recommending the final outcome of the A50 determination process and preparing the correspondence to the Vendors regarding the outcome.
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Reviewing the process and analysis performed when a vendor applicant is denied; creating exception documents as needed for the denials.
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Exceling at performing complex studies and investigations in the development of policies, processes, and programs; compiling and analyzing data and completing the annual Federal WIC Vendor monitoring report(s).
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Submitting The Integrity Profile (TIP) report on behalf of the entire State of Arizona WIC program on the yearly basis.
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Preparing status reports, sanction and trend summaries of vendor monitoring for management oversight.
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Supporting a diverse multi-cultural workforce that reflects the community, promotes equal opportunity at all levels of ADHS, and creates an inclusive work environment that enables all individuals to perform to their fullest potential free from discrimination.

Requirements include:

− Semi-complex knowledge of business law as it relates to Regulatory Judicial Court System; in-depth knowledge of the Federal and State Laws, Rules and Regulations

− Skills in investigation techniques, accounting and auditing methods; oral and written communication, including excellent interpersonal, working relationships and listening skills

− Must obtain a valid fingerprint clearance card issued pursuant to A.R.S. 41-1758.07 or must apply for a fingerprint clearance card within seven working days after beginning employment

− Possession of and ability to retain a current, valid state-issued driver’s license appropriate to the assignment. Employees who drive on state business are subject to driver’s license record checks. Must maintain acceptable driving records and must complete any required training (See Arizona Administrative Code R2-10-207.12)
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Performance management (PM) model and continuous quality improvement (CQI) methods in a public health setting

Preferred Qualifications:
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ArcGIS Mapping Software
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Paralegal Certificate
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Any related basic and/or advanced program (nationally certified) Investigator/Inspector Training
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Principles of Administrative law (some type of training/background)
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Advanced training in creating maps using global information systems software.
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Preference will be given to candidates with prior Public Health experience

Benefits

The State of Arizona provides an excellent comprehensive benefits package including:

− Affordable medical, dental, life, and short-term disability insurance plans

− Top-ranked retirement and long-term disability plans