Child Care Services Fraud Investigator
11 days ago
El Paso
Job DescriptionJob Title: Child Care Services Fraud Investigator Job Family: Programs Department/Group: Family Services Job Code/ Req#: B18/1353 Location: El Paso, TX Travel Required: Some travel in WSB region (West Texas) and state. Level/Salary Range: $50,000 - $55,000 Position Type: Exempt, Full-time Job DescriptionWorkforce Solutions Borderplex is one of 28 public workforce development boards in Texas serving the six-county Borderplex region. We are a non-profit opportunity incubator, personalizing the career path and connecting the right people to the right positions. With the tools, programs, and services we provide, we know you can do anything you put your heart into. Our organization and its initiatives have been recognized and awarded by the Texas Workforce Commission for our innovative approach to assisting employers and job seekers. WSB serves in the spirit of community support. What we do is so important, but we don’t do it alone. We serve the regional business community. Our mission is to help them grow stronger so they can create better jobs. We also prepare people to fill those jobs and achieve a sustaining and fulfilling career. WSB exhibits a growth mindset. We seek individuals who buy into this mission and lead by example by being good stewards of our financial resources, work efficiently to stretch our resources, and support the organization and its community partners so we can collectively elevate the regional economy. Our values include transparency, innovation, accountability, research-driven, impact-driven, integrity, collaboration, and empathy. Join this high-performing team and support a thriving regional economy! SUMMARY/OBJECTIVE Performs moderately complex investigative, compliance, and technical assistance work related to Child Care Services program integrity and fraud prevention. Work involves conducting investigations, reviewing documentation, interviewing relevant parties, preparing findings and recommendations, and collaborating with internal and external partners to ensure compliance with Texas Workforce Commission requirements and Child Care Development Fund (CCDF) regulations. ROLE AND RESPONSIBILITIES • Conduct investigations into allegations of fraud, waste, abuse, and non-compliance involving CCS participants and childcare providers, • Review eligibility documentation, income verification, employment records, residency documentation, attendance records, and provider billing submissions, • Conduct interviews with parents, providers, employers, staff, and third-party contacts as necessary, • Analyze documentation, records, and data to identify inconsistencies, trends, or potential fraudulent activity, • Prepare detailed investigative reports, summaries of findings, and recommendations for corrective action, • Support overpayment identification, calculation, and recovery documentation processes, • Coordinate with CCS eligibility staff, monitoring teams, legal counsel, and Texas Workforce Commission staff, • Assist with documentation required for appeals, hearings, audits, and compliance reviews, • Maintain secure and confidential handling of sensitive records and personally identifiable information, • Identify process gaps, internal control weaknesses, and opportunities for fraud prevention improvements, • Assist in developing procedures, workflows, and guidance related to fraud investigations and program integrity, • Conduct field visits and on-site investigations as needed Bachelor’s degree from an accredited four-year college or university in Criminal Justice, Public Administration, Business, Social Services, Accounting, or a related field is preferred. Minimum 3–5 years of relevant professional experience in one or more of the following areas: • investigations, • compliance, • auditing, • fraud detection, • public benefits eligibility, • case management review Must possess a valid Texas driver’s license and meet requirements to be included as an authorized driver on the Workforce Solutions Borderplex commercial insurance policy. KNOWLEDGE, SKILLS, ABILITIES Knowledge of: • federal and state Child Care Services regulations, • Texas Workforce Commission policies and procedures, • investigative methods and documentation standards, • public benefits eligibility requirements, • compliance monitoring and audit principles, • analyzing records and identifying discrepancies, • conducting objective investigations, • preparing clear and detailed written reports, • interviewing and fact-finding, • using Microsoft Office products and case management systems, • gather, assemble, and analyze facts and evidence, • apply policy and regulations consistently, • communicate effectively both orally and in writing, • maintain impartiality and confidentiality, • work independently and manage multiple investigations simultaneously, • provide recommendations for corrective action and process improvements JOB SPECIFIC COMPETENCIES • Attention to Detail: Ensures information is complete and accurate; follows up with others to ensure that agreements and commitments have been fulfilled., • Data Gathering & Analysis: Seeks or collects and synthesizes information from a variety of stakeholders and sources in an objective, unbiased manner to reach a conclusion, goal, or judgment, and to enable strategic and leadership decision making., • Problem Solving: Identifies problems and uses logic, judgment, and data to evaluate alternatives and recommend solutions to achieve the desired organizational goal or outcome., • Decision Making: Obtains information and identifies key issues and implications to make informed and objective decisions., • Decision Quality: Makes sound decisions that take into account objectives, risks, implications, and agency and governmental regulations., • Conflict Resolution: Uses a variety of approaches to manage and resolve concerns, disagreement, and conflict., • Planning & prioritization: Plans and organizes work activities; manages several tasks at once., • Adaptability: Adapts quickly to change and easily considers new approaches., • Results orientation: Focuses on desired results and sets and achieves challenging goals, • External & Organizational Awareness: Identifies and understands how internal and external issues (e.g., economic, political, social trends) impact the work of the organization., • Risk Analysis: Identifies and manages the risks of failing to detect a misstatement, caused by inadvertent error or fraud that is material to financial statements. GENERAL/ORGANIZATIONAL COMPETENCIES • Quality/Compliance: Achieving a standard of excellence with our work processes and outcomes, honoring the organization's policies and all regulatory requirements., • Customer focus: Striving for high customer satisfaction, going out of our way to be helpful and pleasant, making it as easy as possible on the customer rather than our department or the organization., • Communication: Balancing listening and talking, speaking, and writing clearly and accurately, influencing others, and keeping others informed., • Collegiality/Collaboration: Being helpful, respectful, approachable and team oriented, cooperating with others, inside and outside the organization, to accomplish objectives to build and maintain mutually beneficial partnerships, leverage information, and achieve results., • Initiative: Taking ownership of our work, doing what is needed without being asked, following through, • Efficiency: Planning, managing time well, being on time, being cost conscious, thinking of better ways to do things., • Continuous Learning & Self Development: Being receptive to feedback, willing to learn, embracing continuous improvement, proactively investigating new perspectives, approaches, and behaviors., • Integrity/Transparency: Upholds social, ethical, and organizational norms and values; firmly adheres to codes of conduct and ethical principles; behaves consistently, and is open, honest, and trustworthy; acts without consideration of personal gain. Additional Notes Must possess a valid driver’s license and meet requirements to be included as an authorized driver on the Workforce Solutions Borderplex Commercial Package Policy as stipulated by the insurance carrier. Successful clearance of local and/or state background checks. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice based on business needs. EEO/ADA Workforce Solutions Borderplex provides equal employment opportunities to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Flexible Schedule (with set parameters): Select a shift start and end time between 7:00 AM and 6:00 PM. Monday–Thursday: Working hours must be between 7 and 10 hours per day. Friday: Working hours must be 8 hours or less. A 1‑hour lunch break is required. Total net work hours must equal 40 hours per week.
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