Benjamin J. Carmody Email and Phone Number

Healthcare Fraud Investigator

Manage Professionals, including determining work assignments and amounts, delegating tasks, guiding decision making, coaching, and professional development.Make policy and procedure decisions pertaining to the Child Development and Care (CDC) program for the State of Michigan through the interpretation and implementation of the federal Child Care and Development Block Grant (CCDBG).Create personal methods of tracking my work and that of my direct reports.Assist the Program Director with work pertaining to continuous policy and procedure changes, ensuring compliance with state and federal law and guidelines, including project leadership of CCDBG reauthorization implementation.Conduct and participate in various interdepartmental and cross departmental information sharing and decision-making meetings, including representing the CDC program in the State of Michigan’s overhaul of the assistance application process.Write specialized policy for populations, such as Flint, related to the water crisis.Collaborate with technology professionals to manage and implement policy, ensuring technology support for eligibility determinations and issue tracking.Provide guidance, concise explanation, and final recommendations to the Program Director and Deputy Superintendent.Create job aids, webinars, and other training tools for statewide implementation of policies, and ensure the accuracy of documents created by other offices through the thorough review, comment, and approval of such documents.Note: Beginning in May 2016 this role was considered “Working Out of Class” until I accepted the official position in February 2018.

Conduct analysis and review of provider CDC billing, utilizing parent and provider documents and electronic data for the purpose of identifying discrepancies.Recommend department actions based on reviews, including disqualification, fraud referrals, payment exceptions and recoupment.Instruct childcare providers on proper billing and record keeping methods and interpret CDC policies and procedures.Develop tools for use by the billing analysis unit to create consistency and increase productivity.Serve on special projects and committees for a range of policy and procedure issues and changes.

Determine financial eligibility of subsidy programs for low income families through asset, income and expense verification under State of Michigan policies.Manage a case load using organizational skills, customer service, documentation, and computer programs.Create new systematic approaches and documents in order to meet standards of promptness while maintaining accuracy.(Beginning November 2011) Added responsibility of the Medicaid Long Term Care unit, determining more complex asset and income eligibility for nursing home patients and in-home care patients.