Job Duties (Summary):
- Conducts in-house and field investigations of child day care eligibility and provider payments in accordance with the Ohio Administrative Code (OAC) and Federal, State & Local laws; determines whether noncompliance or non-reporting occurred leading to inaccurate payment(s); determines inappropriate benefits received and recoupments required; conducts interviews; responds to referrals of OAC rule violations involving overpayment & fraud, eligibility, payment, health & safety, and environmental safety related issues. Retains detailed records of investigations; prepares in-depth investigative reports, outlining critical eligibility and provider rule violations & policy standards while determining future risk assessment in child care homes; prepares case summary documentation, evidence, dispositions, &/or revocation letters for departmental staff, management, hearing officer(s), consumer appointed attorneys, and/or County Prosecutor’s Office.
- Completes Child Care pay adjustments for certified providers and Child Care centers, determining the appropriate discovery date and overpayment period(s); applies knowledge of the Child Care OAC regulations for Child Care eligibility and Ohio ECC EPPIC and CCIDS to calculate the pay adjustments; utilizes CRIS-E, SACWIS/SETS, Microsoft products, agency mainframe system (DCMU), Oracle and other office equipment as tools in gathering, compiling and entering data as part of the pay adjustment and overpayment calculation and documentation.
- Consults with and coordinates investigatory efforts with inter-departmental management, ODJFS Program Integrity, law enforcement, licensing authorities, attorneys, County Prosecutor & other community agencies with regard to allegations, evidence, risk assessment, case plans, and corrective action summaries necessary to ensure the safety and well-being of children in the home and the accurate billing/payment for child care services; responds to intra-agency and inter-agency demands (i.e. Fraud, Overpayment & Recovery, & Children Services) to assist with criminal prosecution and testify in court when necessary; reports infractions to management of misconduct or infractions of agency policy, OAC/ ORC rules violations discovered in the investigatory process perpetrated by Home Provider Specialist staff.
- Provides functional supervision & support to inter-departmental staff involved in the investigative process; consults with management; develops staff training, prepares appeal or enforcement hearing strategies and testimony, and makes critical decisions with regard to the regulatory status of Type B, child care homes.
- Represents the department in Agency Hearings, defending case disposition(s) before a neutral Hearing Officer. Prepares case exhibits, contacts and cross examines witnesses, summarizes fact, develops investigative summaries, and presents credible evidence to support case disposition(s); available to testify in a court of law, if further challenged.
- Assists in best case management practices and the joint sharing & dissemination of information with Hamilton County’s Public Children Services Agency (PCSA), Fraud, and Overpayment & Recovery with regard to assessment, service planning, and the coordination of service(s).
- Participates in necessary staff meetings and training to remain current on policies, procedures, and revisions in accordance with the Ohio Administrative Code (OAC); performs other related duties as assigned