SUPERVISING PROGRAM SUPPORT SPECIALIST, QUALITY CONTROL
Quality Control
Career Family: PROGRAM SUPPORT SPECIALIST
New Jersey treats Supervising Program Support Specialist, Quality Control as a competitive-class job, so the gate is an examination and the ranked list it produces rather than a direct offer.
The spec names a master's degree, but it leaves the door open to substitute experience for the degree. The FY2027 range lands between $95,955 and $141,386.
How to apply
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Exam
This is an application to sit an exam and be placed on an eligible list for this title, not an application for a specific job. A $35 application fee applies to Non-Public-Safety announcements issued on or after 2026-02-01. There may be no current vacancy behind it, and the list it produces may not be certified for months or years.
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Exam
Open to permanent employees in the competitive division who hold a qualifying lower title in the same unit. A $35 application fee applies to Non-Public-Safety announcements issued on or after 2026-02-01. Like the open competitive exam, this places you on a list; it is not itself a job offer.
Official job specification
The text below is the official specification published by the New Jersey Civil Service Commission. The plain-language summary and analysis above are derived from it by NJ Civil Service Navigator.
Definition
Under direction of an administrative official in the Department of Human Services, supervises the work of a professional unit responsible for performing quality control reviews and audits of eligibility determinations for state and federal assistance programs and implementing internal control systems to reduce fraud, abuse, and eligibility errors; directs the development and modification of quality control audit programs and pilots to meet state and federal mandates; serves as a subject matter expert for the development and implementation of quality control programs; and oversees the development of quality control policies and procedures; supervises staff and work activities; prepares and signs official performance evaluations for subordinate staff; does other related duties as required.
Examples of work
Directs the development, modification, and implementation of an extensive quality control program to monitor eligibility determination for state and federal social service, healthcare, and financial assistance programs. Directs the performance of in-depth and complex analytical reviews and audits of case documentation to verify that contractors, vendors, and government agencies are accurately determining eligibility for state and federal social service, healthcare and financial assistance programs and meeting timelines set forth in laws, regulations, and contracts. Develops and/or serves as a subject matter expert to contractors, vendors, and state and local government staff in the development of internal control systems, data tracking and audit tools for monitoring the accuracy of eligibility determinations, evaluating the effectiveness and efficiency of quality control and monitoring systems, and recommending improvements for system and process upgrades and modifications. Researches, analyzes, and evaluates proposed, new, and current federal/state laws and regulations relating to government-sponsored programs to ensure that eligibility determinations are being made in accordance with regulations set forth by the Centers for Medicare & Medicaid Services (CMS) and/or other governing bodies. Oversees the development of production goals and ensures that staff are meeting agency, state, and federal regulations and requirements. Monitors and evaluates staff in the performance of their work and develops training programs to address identified areas of development. Supervises the work operations and/or functional programs and has responsibility for effectively recommending the hiring, firing, promoting, demoting, and/or disciplining of employees. Supervises the preparation of special project plans and audits including setting goals, guidelines, instructions, and deadlines for completion of tasks. Acts as liaison with appropriate federal representatives with respect to federal review of state quality control activities. Develops, monitors, and enforces quality control policies and procedures to ensure compliance with federal requirements. Develops evaluation strategies and quality control initiatives to identify deficiencies in acceptable quality control standards and oversees the preparation and enforcement of Corrective Action Plans. Supervises the review, auditing, and enforcement of contracts to ensure that vendors are adhering to state and federal guidelines and regulations for monitoring eligibility determinations for healthcare and other assistance programs. Supervises the coordination of on-site visits and off-site investigations to evaluate the work operations and performance of vendors and contractors providing eligibility determinations for various assistance programs; provides support, guidance, and technical expertise pertaining to quality control requirements, evaluations, and findings; and provides recommendations for improvement when deficiencies are identified. Supervises the resolution of and provides guidance and direction on complex case reviews and subject matter in response to significant deficiencies identified and problems with non-compliance. Assesses the effectiveness of program services through the use of quality control measures. Presents and/or represents the agency at meetings, conferences, and training sessions. Prepares and directs the preparation of clear, sound, accurate, and informative audit, statistical and other reports containing findings, analyses, conclusions, and recommendations. Supervises the establishment and maintenance of essential records and files. Will be required to learn how to utilize various types of electronic and/or manual recording and computerized information system used by the agency, office, or related units.
License
Appointees will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position.
Knowledge, skills and abilities
Knowledge of the objectives of human support service programs and Public Assistance Program policy. Knowledge of the activities and responsibilities of agencies involved in the field of Quality Control. Knowledge of state and federal regulations, including those developed by the Centers for Medicare & Medicaid Services (CMS), regarding quality control requirements for government-administered healthcare programs. Knowledge of Medicare, Medicaid, state and federal health insurance marketplaces, and associated state and federal programs. Knowledge of the procedures and methods used in the enforcement of regulations of a regulatory agency or organization. Knowledge of the quality control procedures and legal standards. Knowledge of accepted policies and procedures related to sound management techniques and their application. Knowledge of the methods used to gather and analyze data. Knowledge of research methods and techniques. Ability to analyze laws, regulations, rules, policies, and procedures, interpret them in accordance with established quality control policies and apply them to assigned programs and specific situations. Ability to gather and analyze data. Ability to operate and interpret information contained on the SDX, Benedex, and CODES terminal. Ability to draft, analyze, and interpret pending legislation, policies, and procedures; identify problematic areas and recommend corrective action. Ability to read, analyze, and interpret RFP's, contracts, and other legal documents to monitor and enforce the provisions of contracts. Ability to comprehend the components of a vendor's case review system. Ability to monitor and analyze pending legislation, federal and state policies, regulations, laws, rules, and administrative orders for changes and compliance. Ability to identify and resolve problems in the delivery, administration, implementation, or integration of quality control activities. Ability to interpret the purpose and programs of services provided to clients, vendors, other state agencies, and community organizations. Ability to audit eligibility determinations for an assistance program. Ability to provide guidance and technical assistance to stakeholders. Ability to identify potential fraud or abuse. Ability to act as a liaison between the agency and other public and/or private organizations. Ability to determine new program initiatives to improve service delivery and quality control measures. Ability to develop quality control audit measurement tools and data tracking systems. Ability to assign, instruct, and supervise the work performance of staff. Ability to supervise assigned staff and plan, organize, and implement projects within the unit. Ability to collect, compile, and accurately interpret factual information relating to specific program activities. Ability to supervise site visits, studies, and investigations. Ability to work cooperatively with department staff and other state agencies. Ability to represent the agency in public meetings and conferences. Ability to analyze work assignments and develop effective work methods. Ability to prepare clear, sound, accurate, and comprehensive reports containing findings, conclusions, and recommendations. Ability to supervise the establishment and maintenance of essential records and files, including client files. Ability to learn how to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units. Ability to read, write, speak, understand, and communicate in English sufficiently to perform the duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication. Persons with mental or physical disabilities are eligible if they can perform the essential functions of the job with or without reasonable accommodation. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible.
Note
The examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed. Applicants must meet one of the following or a combination of both experience and education. Thirty (30) semester hour credits are equal to one (1) year of relevant experience. Eight (8) years of professional experience in a public or private agency responsible for providing social services or financial assistance for its clients, primary responsibility being monitoring or auditing social or human services programs, services, or client eligibility; or developing and implementing internal control systems and quality control programs; or performing other quality control activities; one (1) year of which shall have been in a supervisory capacity. Examples of programs are: Aged, Blind and Disabled (ABD) program, Children's Health Insurance Program (CHIP), Presumptive Eligibility (PE), and Specified Low Income Medicare Beneficiary (SLIMB). Examples of quality control activities are: reviewing cases to ensure eligibility has been determined properly; validating documents; verifying recipients are receiving aid they are supposed to be receiving; investigating reports of assets, income, etc. to confirm a recipient should be receiving benefits based on the information they provided on their application, etc. OR Possession of a bachelor's degree from an accredited college or university; and four (4) years of the above-mentioned professional experience, one (1) year of which shall have been in a supervisory capacity. OR Possession of a master's degree in social work, psychology, education, public administration, business administration, or a related field from an accredited college or university; and three (3) years of the above-mentioned professional experience, one (1) year of which shall have been in a supervisory capacity. "Professional experience" refers to work that is creative, analytical, evaluative, and interpretive; requires a range and depth of specialized knowledge of the profession's principles, concepts, theories, and practices; and is performed with the authority to act according to one's own judgment and make accurate and informed decisions.