MEQC ReviewerManagement Analyst I

New Castle, CO - USA

Monthly Salary: Not Disclosed

Posted on: 7 hours ago

Vacancies: 1 Vacancy

Job Summary

Job Title: MEQC Reviewer/Management Analyst I (1 Opening)

Job Location: Lewis Bldg 1901 N. Dupont Hwy New Castle DE (Onsite)

Type: 12 Months

Job Description:

This position plays a key role in ensuring that Medicaid and CHIP eligibility decisions are made in compliance with federal and state regulations. As part of the MEQC review team you will conduct in-dept case reviews validate eligibility determination assess supporting documentation and help identify errors and patterns that inform system improvements.

Responsibilities:

Review and analyze Medicaid and CHIP active and negative case files for accuracy and compliance.
Compare eligibility decisions with applicable state and federal policy requirements including MAGI and non-MAGI pathways.
Identify and document discrepancies error trends and root causes.
Track and report findings using Excel Adobe and internal systems like ASSIST Worker Web and DMES.
Prepare clear policy-cited written summaries of case reviews suitable for audit and federal reporting.
Maintain organized audit-ready digital documentation.
Collaborate with team members to identify root causes of errors and support corrective actions.

Who Should Apply:

We welcome candidates from a variety of professional backgrounds who are:

Analytical and highly attentive to detail.
Comfortable working with case files policy references and digital systems and be able to work autonomously to ensure objectivity in case reviews.
Proficient with Excel and Adobe PDF (e.g. filling out forms annotations commenting etc.).
Strong written and verbal communicators who can document and explain complex findings.
Skilled at managing confidential information with care and professionalism.

Preferred but Not Required:

Experience using systems like Delawares eligibility determination system - ASSIST Worker Web DMES or other eligibility/case management systems.
Familiarity with Medicaid or other public assistance program eligibility rules.
Background in compliance quality control auditing or case management.

Why Join:

Be part of a federally required high-impact quality assurance initiative.
Contribute directly to program integrity and continuous improvement in Medicaid service delivery.
Gain valuable experience in policy interpretation audit processes and eligibility quality control.
Work in a supportive mission-driven environment with opportunities for learning and growth.

Job Title: MEQC Reviewer/Management Analyst I (1 Opening) Job Location: Lewis Bldg 1901 N. Dupont Hwy New Castle DE (Onsite) Type: 12 Months Job Description: This position plays a key role in ensuring that Medicaid and CHIP eligibility decisions are made in compliance with federal and state regul...