Full Job Description
As a direct report to the Director of Program Integrity, this position has oversight of the business unit responsible for leading the organizations' effort to prevent, detect, and recover unemployment insurance overpayments. They will manage, plan, organize and control all operations and activities of DUA's agencywide program integrity strategy and functions.
MAJOR RESPONSIBILITY AREAS
• The Program Integrity Manager plays a crucial role in maintaining the integrity of the unemployment insurance (UI) system by overseeing the investigation and resolution of fraudulent activities. This leadership position is responsible for guiding a team of investigators, ensuring compliance with relevant regulations, and enhancing the effectiveness of fraud detection and prevention measures.
• Review and analyze UI claim data, employer records, and system transactions to detect inconsistencies and potential fraud. Ensure that advanced analytical tools and techniques are effectively utilized to recognize patterns and anomalies.
• Ensure all investigative actions and recommendations comply with federal and state laws, as well as departmental policies. Stay updated on changes in legislation and best practices related to unemployment fraud. Flag suspicious employer accounts and fraudulent claims for further investigation. Coordinate with other departments and external agencies to resolve complex cases.
• Collaborate with legal teams, enforcement agencies, and other stakeholders to support investigations and ensure thorough resolution of fraud cases.
• Supervise the examination of employer records to ensure compliance, making necessary updates with proper documentation in accordance with federal Department of Labor guidelines. Oversee regular compliance checks to confirm adherence to laws and regulations. Supervise the compilation and preparation of case files for referral to the Office of the Attorney General, ensuring that all documentation is up-to-date and sent timely. Manage communications with employers to clarify compliance requirements, resolve issues, and provide support as needed.
• Responsible for managing the Benefit Collections Team and ensuring that all overpayment checks are processed, deposited, and reconciled in a timely manner. Coordinates with EOLWD Finance to ensure proper accounting, reconciliation, and resolution of any payment discrepancies.
• Oversee all benefit-related payments to and from the agency involving claimants and external entities. This includes, but is not limited to, Interstate Reciprocal Overpayment Recovery Arrangement (IRORA) payments, child support withholdings, Treasury Offset Program (TOP) payments, state intercept refunds, and other benefit recovery transactions. Coordinates with financial institutions and external stakeholders to ensure effective processes are in place, resolve payment discrepancies, and maintain compliance with applicable federal and state requirements.
• Provide leadership, supervision, and performance management for Program Integrity staff by monitoring employee productivity, quality, and compliance using reports, system queries, dashboards, and other performance metrics. Conduct regular performance reviews, prepare employee evaluations, provide coaching and developmental feedback, and address performance concerns in a timely manner. Manage employee relations issues, including addressing workplace conflicts and fostering a collaborative and professional work environment. Work closely with Human Resources and Labor Relations to ensure appropriate documentation, progressive discipline, and corrective actions are administered in accordance with agency policies, collective bargaining agreements, and applicable laws and regulations.
• Undertake special projects assigned, including system and analytical tool testing, development and implementation of new investigative techniques, and participation in inter-departmental initiatives. Contribute to strategic efforts to enhance fraud detection and prevention, supporting the continuous improvement of the department's capabilities.
Qualifications:
MINIMUM ENTRANCE REQUIREMENTS: Applicants must have at least (A) five (5) years of full-time or, equivalent part-time, professional, professional internship, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management or (B) any equivalent combination of the required experience and substitutions below. Substitutions: I. A certificate in a relevant or related field may be substituted for one (1) year of the required experience. II. A Bachelor's degree in a related field may be substituted for two (2) years of the required experience. III. A Graduate degree in a related field may be substituted for three (3) years of the required experience. IV. A Doctorate degree in a related field may be substituted for four (4) years of the required experience.
Comprehensive Benefits
When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.
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