SSA ORGANIZATIONAL MANUAL

Chapter TQ

OFFICE OF ANALYTICS, REVIEW, AND OVERSIGHT


  1. Mission

    The Office of Analytics, Review, and Oversight (OARO) (TQ) supports the agency’s mission, goals, and service principles by reviewing program quality and effectiveness; making recommendations for program improvement using feedback from the adjudication of cases, predictive modeling, and advanced data analysis; coordinating the agency’s detection and prevention of fraud; and responding to recommendations of external monitoring authorities.
  2. Organization
    1. The Deputy Commissioner for Analytics, Review, and Oversight (TQA)
    2. The Assistant Deputy Commissioner for Analytics, Review, and Oversight (TQA)
    3. The Immediate Office of the Deputy Commissioner for Analytics, Review, and Oversight (TQA)
      1. The Audit Liaison Staff (TQA-1)
    4. The Office of Analytics and Improvements (TQB)
      1. The Division of Analytics Center of Excellence (TQBA)
      2. The Division of Analysis, Development, and Support (TQBB)
      3. The Division of Automated Solutions (TQBC)
      4. The Division of Continuous Improvement Programs (TQBE)
      5. The Division of Enterprise Program Management (TQBG)
      6. The Division of Management Analysis (TQBH)
      7. The Division of Modeling (TQBJ)
    5. The Office of Anti-Fraud Programs (TQC)
      1. The Division of Analytics and Operations (TQCA)
      2. The Division of Inquiries and Adjudications (TQCB)
      3. The Division of Policy, Planning, and Programs (TQCC)
    6. The Office of Appellate Operations (TQE)
      1. The immediate Office of Appellate Operations (TQE)
        1. The Medical Support Staff (TQE-1)
        2. The Program Analysis Staff (TQE-2)
      2. Director of Operations (TQEA)
        1. The Division of Civil Actions (TQEAA)
        2. The Divisions of Program Adjudication I – IX (TQEAB – TQEAM)
        3. The Division of Quality Review (TQEAN)
        4. The Division of Program Support (TQEAP)
    7. The Office of Quality Review (TQG)
      1. The Division of Disability Quality (TQGA)
      2. The Division of Review Automation Support (TQGB)
      3. The Division of Title II Quality and Special Studies (TQGC)
      4. The Division of Title XVI Quality and Service Evaluation (TQGE)
      5. The Field Site Operations – Baltimore (TQG-FA)
      6. The Field Site Operations (TQG-F through TQG-FX)
  3. Functions
    1. The Deputy Commissioner for Analytics, Review, and Oversight (TQA) is directly responsible to the Commissioner for carrying out the OARO mission and providing managerial direction to the major components of OARO.
    2. The Assistant Deputy Commissioner for Analytics, Review, and Oversight (TQA) assists the Deputy Commissioner in carrying out his/her responsibilities and performs other duties as the Deputy Commissioner may assign.
    3. The Immediate Office of the Deputy Commissioner for Analytics, Review, and Oversight (TQA) provides the Deputy Commissioner and Assistant Deputy Commissioner with staff assistance on the full range of his/her responsibilities. It reviews and analyzes existing and proposed formal delegations of program and administrative decision-making authorities within SSA. Provides information technology (IT) support to OARO staff (e.g., network support, hardware and software installation and maintenance, security, infrastructure, application development, and web and SharePoint maintenance and support).
      1. The Audit Liaison Staff (TQA-1) directs SSA’s participation in the audit programs conducted by the United States Government Accountability Office (GAO), the Office of the Inspector General (OIG), and other external organizations. Develops agency positions on issues presented in the audits, reviews, and evaluates audit reports, and monitors and evaluates the implementation of GAO and OIG audit reports and internal survey recommendations.
    4. The Office of Analytics and Improvements (TQB) promotes the sharing of information across organizational boundaries that allows managers to make informed decisions and improves processes to reduce errors and improper payments. The Office provides a variety of services to agency management, including business process models, data analytics, geospatial visualizations, risk analyses, automated solutions, continuous improvement solutions, and statistical predictive models. The Office also identifies and addresses emerging quality issues based on data trends and root cause analysis and works with operating components to implement and facilitate quality improvements. The Office develops software and techniques that identify and correct errors, and provides automated assistance to technicians and managers. The Office also develops models that allow managers to assess the effect of business process or policy changes, and changes in staffing plans, provides sophisticated analysis on the probability of meeting agency goals and targets, and provides horizontal agency-wide data analytics based on authoritative data sources and geospatial visualizations. The Office supports the agency’s data quality activities and manages updates, and designs quality selection models across operating components. The Office enhances SSA’s programs and processes through management consultation, data analytics, and innovative business solutions. The Office provides centralized, highly skilled data analytics resources to assist agency components in conducting deep-dive analytics and research projects. Performs agency-level performance gap analyses and provides results from deep-dive data analyses to determine performance gaps in achieving agency performance measure targets, including agency priority goals.
    5. The Office of Anti-Fraud Programs (TQC) provides centralized oversight of and accountability for the agency’s anti-fraud initiatives. The Office provides leadership and direction to SSA’s anti-fraud framework, leads a comprehensive approach to agency fraud prevention, and aligns anti-fraud efforts with industry standards.
    6. The Office of Appellate Operations (TQE) consists of the Appeals Council and its support staff. In accordance with a direct delegation from the Commissioner of Social Security, the Appeals Council is the final level of administrative review under the Administrative Procedure Act for claims filed under the titles II, VIII, and XVI of the Social Security Act, as amended (the Act). The Executive Director of OAO serves as the Chairperson of the Appeals Council and is responsible for the day-to-day operations of a program of administrative review of administrative law judge (ALJ) decisions and other actions issued under the provisions of the Act. Upon claimant request or on the Appeals Council’s own motion, reviews ALJ decisions and other actions involving claims for benefits filed under titles II, VIII, and XVI of the Act. The Appeals Council may identify cases that raise important questions of law or policy, and conduct oral argument before issuing decisions in such cases. Based upon its review of these or other cases, the Council may establish binding adjudicatory standards and decisional principles that governs OARO’s adjudicatory process. Tracks and analyzes court case trends and disseminates information to guide adjudicators with respect to case law, to implement an effective appeals strategy, and to identify areas and make recommendations as to policies which need to be developed and/or clarified, new regulations which need to be developed or clarifying legislation that should be sought. Also administers the congressional and public inquiries activities for the organization.
    7. The Office of Quality Review (TQG) reviews, evaluates, and reports on the integrity and quality of the administration of Social Security programs in headquarters and in the field. The Office conducts broad-based reviews, studies, and analyses of agency operations with emphasis on compliance with laws, regulations, and policies. The Office also establishes quality review policy for the OARO field reviewers, analyzes and reports on results, and recommends changes in programs, policies, or legislation aimed at quality and productivity improvement and program simplification. The Office assesses the medical determinations made by the State and Federal disability determination components and decisions by the Office of Hearings Operations, including decisions by Senior Attorney Advisors and Administrative Law Judges. The Office evaluates the quality of the agency’s operations with emphasis on the prevention of program and systems abuse, the elimination of waste, and the increase of efficiency. The Office also performs customer surveys that measure the public’s perceptions of the agency’s service delivery and provides insights for agency planning. The Office leads the development and maintenance of the quality assurance systems that support nationwide studies and reviews.

 

SSA ORGANIZATION MANUAL

Subchapter TQB

OFFICE OF ANALYTICS AND IMPROVEMENTS

  1. Mission

    The Office of Analytics and Improvements (OAI) (TQB) promotes the sharing of information across organizational boundaries that allows managers to make informed decisions and improves processes. The Office provides a variety of services to agency management, including business process models, data analytics, geospatial visualizations, risk analyses, automated solutions, continuous improvement solutions, and statistical predictive models. The Office also identifies and addresses emerging quality issues based on data trends and root cause analysis and works with operating components to implement and facilitate business improvements. The Office develops software and techniques that identify and correct errors, and provides automated assistance to technicians and managers. The Office also develops models that allow managers to assess the effect of business process or policy changes, and changes in staffing plans, provides sophisticated analysis on the probability of meeting agency goals and targets, and provides horizontal agency-wide data analytics based on authoritative data sources and geospatial visualizations. The Office enhances SSA’s programs and processes through management consultation, data analytics, and innovative business solutions. The Office performs agency-level performance gap analyses and provides results from deep-dive data analyses to determine performance gaps in achieving agency performance measure targets, including agency priority goals.
  2. Organization
    1. The Associate Commissioner for Analytics and Improvements (TQB)
    2. The Deputy Associate Commissioner for Analytics and Improvements (TQB)
    3. The Immediate Office of the Associate Commissioner for Analytics and Improvements (TQB)
    4. The Division of Analytics Center of Excellence (TQBA)
    5. The Division of Analysis, Development, and Support (TQBB)
    6. The Division of Automated Solutions (TQBC)
    7. The Division of Continuous Improvement Programs (TQBE)
    8. The Division of Enterprise Program Management (TQBG)
    9. The Division of Management Analysis (TQBH)
    10. The Division of Modeling (TQBJ)
  3. Functions
    1. The Associate Commissioner for Analytics and Improvements (OAI) (TQB) is directly responsible to the Deputy Commissioner for Analytics, Review, and Oversight to carry out OARO and OAI's mission and provide general supervision to the major components of OAI.
    2. The Deputy Associate Commissioner for OAI (TQB) assists the Associate Commissioner in carrying out his/her responsibilities and performing other duties as the Associate Commissioner may prescribe.
    3. The Immediate Office of the Associate Commissioner for OAI (TQB) provides the Associate Commissioner with staff assistance on the full range of his/her responsibilities.
    4. The Division of Analytics Center of Excellence (TQBA) provides centralized, highly skilled data analytics resources to assist agency components in conducting deep-dive analytics and research projects. Performs agency-level performance gap analyses and provides results from deep-dive data analyses to determine performance gaps in achieving agency performance measure targets, including agency priority goals.
    5. The Division of Analysis, Development, and Support (TQBB) provides a full range of software development and support functions including planning and analysis, requirements gathering, design, development, validation, and implementation of DCARO’s internal programmatic and operational applications. Provides database and server administration, guidance, and technical support. Creates, develops and maintains geospatial applications as analytical tools for both performance and workload measurement and management. Provides expertise and agency support for data visualization efforts. Supports the Business Intelligence initiative, and leads the agency’s data quality initiative and the development of a comprehensive data quality plan.
    6. The Division of Automated Solutions (TQBC) develops software and techniques to evaluate quality, identify errors, and process actions to change agency records. Mines data from multiple sources and organizes it for use by other components throughout the agency for studies, corrective actions, and recommendations for policy changes. Collaborates with other agency components to identify problems and develop solutions designed to increase accuracy, productivity, and timeliness while reducing costs, improving service, and preventing improper payments and missed entitlements. Conducts studies and provides data analysis in the earnings enforcement and earnings suspense areas to support program integrity. Develops assistive tools and utilities to address issues that affect the quality, accuracy, and efficiency of the agency’s work.
    7. The Division of Continuous Improvement Programs (TQBE) fosters excellence in quality performance across the agency by continually evaluating processes, policies, and procedures to identify opportunities for improvement. Collaborates with other components to develop solutions to improve quality; provides project management services; conducts post-implementation assessments of major agency initiatives; analyzes business processes for streamlining and enhancement; and conducts internal surveys to capture employee feedback. Promotes continuous improvement and knowledge management.
    8. The Division of Enterprise Program Management (TQBG) conducts data-driven reviews and monitors and reports on the progress achieved toward agency performance measures and agency priority goals. Produces strategic documents and management information reports that provide timely, objective, and pertinent information regarding the agency’s performance on mission critical projects. Provides agency executives and external entities with strategic documents and management information reports to track agency’s progress in meeting its strategic goals and objectives. Analyzes agency-wide plans and proposals to identify potential conflicts, synergies, and interdependencies with other plans, projects, and proposals. Supports data-driven decisions, tracks, monitors, and maintains agency-level management information, and performs complex data analyses resulting in comprehensive management information reports that highlight agency progress toward performance objectives and identify areas in need of improvement.
    9. The Division of Management Analysis (TQBH) directs, develops, and conducts agency wide reviews and studies, using industrial engineering, model building, and other scientific approaches and methodologies. Provides predictive analytics for agency workloads and processes. Documents business processes, determines tasks times, and the related staffing and hours worked. Uses business process simulation to predict the attainment of goals, processing times, or pending workloads. Creates risk analyses to gauge the likelihood of meeting the predictions. Optimizes the results of a business process simulation or risk analysis to highlight potential changes to produce better results. Supports the agency through predictive analytics to test pilot processes and the impact of automation changes.
    10. The Division of Modeling (TQBJ) creates, refreshes, and maintains statistical predictive models based on past outcome data to predict future outcomes. These models allow cost-effective targeting of agency resources for workloads such as SSI redeterminations, disability pre-effectuation reviews, and Medicare Part D reviews. Conducts research studies of agency programs and management issues designed to improve the efficiency of operational workloads. Manages, updates, and designs quality selection models across operating components. Provides statistical consultation for DCARO and the agency on issues such as sample size and study methodology.

 

SSA ORGANIZATION MANUAL

Subchapter TQC

OFFICE OF ANTI-FRAUD PROGRAMS

  1. Mission

    The Office of Anti-Fraud Programs (OAFP) provides centralized oversight of and accountability for the agency’s anti-fraud initiatives. The Office provides leadership and direction to SSA’s anti-fraud framework, leads a comprehensive approach to agency fraud prevention, and aligns anti-fraud efforts with industry standards.
  2. Organization
    1. The Associate Commissioner, Office of Anti-Fraud Programs (TQC)
    2. The Deputy Associate Commissioner, Office of Anti-Fraud Programs (TQC)
    3. The Immediate Office of the Associate Commissioner, Office of Anti-Fraud Programs (TQC)
    4. The Division of Analytics and Operations (TQCA)
    5. The Division of Inquiries and Adjudications (TQCB)
    6. The Division of Policy, Planning, and Programs (TQCC)
  3. Functions
    1. The Associate Commissioner, Office of Anti-Fraud Programs (OAFP) (TQC) is directly responsible to the Deputy Commissioner for Analytics, Review, and Oversight to carry out OARO and OAFP's mission and provide general supervision to the major components of OAI. The Associate Commissioner is directly accountable for SSA’s anti-fraud efforts.
    2. The Deputy Associate Commissioner, OAFP (TQC) assists the Associate Commissioner in carrying out his/her responsibilities and performs other duties as the Associate Commissioner may prescribe.
    3. The Immediate Office of the Associate Commissioner, OAFP (TQC) provides the Associate Commissioner and Deputy Associate Commissioner with staff assistance on the full range of their responsibilities.
    4. The Division of Analytics and Operations (DAO) (TQCA) is responsible for: operating enterprise anti-fraud analytics and risk scoring solution(s); developing advanced analytical models (e.g., forensics, social network, and anomaly detection); identifying new data sources; and, supporting component-specific initiatives. DAO also acts as a communications hub for anti-fraud actions, findings, and recommendations.
    5. The Division of Inquiries and Adjudications (DIA) (TQCB) is responsible for: performing investigation work, research, analysis, and evaluation of information to conduct, assist, and support comprehensive fraud investigations. DIA is also responsible for: formulating information source search strategies and reviewing data to identify patterns and relationships across financial, criminal, public record, and other information; coordinating investigative activities with Federal, State, and local law enforcement officials in coordination with the Office of the Inspector General; conducting sophisticated surveillance; ensuring criminal cases are supported by evidence; developing supportable cases for presentation and/or prosecution; and, conducting inspections and investigations where significant difficulties are encountered.
    6. The Division of Policy, Planning, and Programs (DPPP) (TQCC) is responsible for: implementing the anti-fraud framework for SSA and supporting the operating model and workforce development initiatives; managing cross component, prioritized anti-fraud initiatives; recommending resource allocations, and acting as program liaison; establishing common performance and outcome-based goals; and, continuously monitoring anti-fraud initiatives. DPPP proposes new initiatives, capabilities, skills profiles, and tools based on leading practices and SSA needs, and develops anti-fraud data strategy and governance plan, and pursues external partnerships, as necessary.

 

SSA ORGANIZATIONAL MANUAL

Subchapter TQE

OFFICE OF APPELLATE OPERATIONS

  1. Mission

    The Office of Appellate Operations (OAO) (TQE) consists of the Appeals Council and its support staff. In accordance with a direct delegation of authority from the Commissioner of Social Security, the Appeals Council is the final level of administrative review under the Administrative Procedure Act for claims filed under titles II, VIII, and XVI of the Social Security Act, as amended. The Executive Director of OAO is the Chairperson of the Appeals Council and is responsible for the day-to-day operations of a program of administrative review of Administrative Law Judge (ALJ) decisions issued under the provisions of the Social Security Act, as amended. Upon claimant request or on the Appeals Council’s own motion, reviews ALJ decisions and dismissals involving claims for benefits filed under titles II, VIII, and XVI of the Social Security Act, as amended. The Appeals Council may identify cases that raise important questions of law or policy, and conduct oral argument before issuing decisions in such cases. Based upon its review of these or other cases, the Council may establish binding adjudicatory standards and decisional principles that govern OARO’s adjudicatory process. Tracks and analyzes court case trends and disseminates information to guide adjudicators with respect to case law, to implement an effective appeals strategy, and to identify areas and make recommendations as to policies which need to be developed and/or clarified, new regulations which need to be developed or clarifying legislation that should be sought. Also administers the congressional and public inquiries activities for OARO.
  2. Organization
    1. The Executive Director for Operations for Office of Appellate Operations (TQE)
    2. The Deputy Executive Director for Office of Appellate Operations (TQE)
    3. The Immediate Office of the Executive Director for Office of Appellate Operations (TQE)
      1. The Medical Support Staff (TQE-1)
      2. The Program Analysis Staff (TQE-2)
    4. The Director of Operations (TQEA)
      1. The Division of Civil Actions (TQEAA)
      2. The Divisions of Program Adjudication I – IX (TQEAB – TQEAM)
      3. The Division of Quality Review (TQEAN)
      4. The Division of Program Support (TQEAP)
  3. Functions
    1. The Executive Director for Office of Appellate Operations (OAO) (TQE) is directly responsible to the Deputy Commissioner for Analytics, Review, and Oversight to carry out OARO and OAO's mission and provide general supervision to the major components of OAO.
    2. The Deputy Executive Director for OAO (TQE) assists the Director in carrying out his/her responsibilities and performs other duties as the Director may prescribe.
    3. The Immediate Office of the Executive Director for OAO (TQE) provides the Executive Director and the Deputy Executive Director with staff assistance on the full range of their responsibilities.
      1. The Medical Support Staff (TQE-1) consists of consulting physicians and support staff and provides expert professional judgment to the Appeals Council on individual disability insurance claims. Provides informational, advisory and consultant services to the Appeals Council and its support staff on matters of interpretation and application of national policy on SSA disability criteria and regulations. Represents OARO in contacts with appropriate professional affiliations, and coordinates with the Office of Retirement and Disability Policy components on all matters of joint interest in the area of medical disability evaluation.
      2. The Program Analysis Staff (TQE-2) provides expert advice to the Executive Director related to the operation and administration of various OARO programs under the Social Security Act, as amended. Reviews and evaluates SSA regulations, Federal Register materials, and legal instruments within OARO’s areas of jurisdiction; proposals for legislation and specifications for such proposed legislation; reports and letters to congressional committees, the Office of Management and Budget, and others on proposed legislation and legislative matters; and proposed testimony of SSA officials before Congress. Ensures that operating procedures and instructions developed to implement the Office of Hearings Operations conform with SSA benefit program policy and the Office of Hearings Operations process policy. Provides advisory services, consultation, and staff assistance to other components of OARO. Maintains ongoing liaison with SSA, Office of Disability Policy, Office of the General Counsel (OGC) and others with respect to program, legislative and policy matters. Reviews current and developing trends in administrative law and litigation; analyzes and prepares recommendations; and develops long-range and short-range plans for hearings and appeals policy matters and OARO’s implementation of benefit program policy matters. Develops and coordinates program training in conjunction with other OARO components.
    4. The Director of Operations (TQEA) directs the operation of the adjudication of claims filed under titles II, VIII, and XVI of the Act, as amended, at the appellate level. Advises the Executive Director on program operating matters, adjudicative trends and related functions. Advises the Appeals Council in program related areas and provides staff assistance to the Administrative Appeals Judges.
      1. The Division of Civil Actions (TQEAA) serves as support staff to the Appeals Council. Prepares the certified administrative record, remand orders, affidavits, and related correspondence on cases in which a complaint has been filed in Federal court. Analyzes and recommends action on cases remanded by the courts, including actions related to final decisions after court remand and those referred by OGC for consideration of whether remand should be requested at the Commissioner’s motion. Within published guidelines, recommends to OGC defense on the record for certain litigated cases, if further administrative action is not warranted. Prepares all certified administrative records and controls and maintains records of claims at the civil actions level that are within the jurisdiction of OARO. Acts as liaison with the Disability Program Branches, the hearing offices, and OGC on writs of mandamus. Provides and/or arranges for translating and reprographics services on cases pending administrative review.
      2. The Divisions of Program Adjudication I – IX (TQEAB – TQEAM) oversees and coordinates activities of the Disability Program Branches and the Retirement and Survivors Insurance and Supplemental Security Income Branches. Serves as support staff providing advice to the Appeals Council in its review of ALJ decisions and dismissals involving claims for benefits. Following an analysis of the record and any additional evidence and/or argument submitted, and applying a thorough knowledge of the Act, regulations, rulings and applicable case law, examines hearing decisions and other final actions of ALJs and requests for Appeals Council review, and makes recommendations to the Appeals Council as to what action should be taken on cases pending before the Council. Analyzes and recommends action on cases remanded by the courts and those referred by OGC for consideration of whether remand should be requested at the Commissioner’s motion. Recommends to OGC defense on the record of certain litigated cases if further administrative action is not warranted. Reviews fee agreements on appeals pending before the Appeals Council and makes a determination to approve or disapprove the agreement based on statutory conditions.
      3. The Division of Quality Review (TQEAN) provides operational support to the Appeals Council in the exercise of its quality review responsibilities overseeing SSA’s nationwide appeals program for claims filed under titles II, VIII, and XVI of the Act. Provides substantive advice and recommendations on individual cases and on the application of Social Security regulations, rulings, etc.
      4. The Division of Program Support (TQEAP) provides support services to the Appeals Council, including reconstruction of lost claim files and receiving and analyzing fee petitions. Maintains a system for the receipt, control, docketing, filing and disposition of claim files and related documents, and controls transcription of hearing recordings in preparation of the official answer to civil actions filed against the Commissioner of SSA.

 

SSA ORGANIZATION MANUAL

Subchapter TQG

OFFICE OF QUALITY REVIEW

  1. Mission

    The Office of Quality Review (OQR) (TQG) reviews, evaluates, and reports on the integrity and quality of the administration of Social Security programs in headquarters and in the field. The Office conducts broad-based reviews, studies, and analyses of agency operations with emphasis on compliance with laws, regulations, and policies. The Office also establishes quality review policy for the OARO field reviewers, analyzes and reports on results, and recommends changes in programs, policies, or legislation aimed at quality and productivity improvement and program simplification. The Office assesses the medical determinations made by the State and Federal disability determination components and decisions by the Office of Hearings Operations, including decisions by Senior Attorney Advisors and Administrative Law Judges. The Office evaluates the quality of the agency’s operations with emphasis on the prevention of program and systems abuse, the elimination of waste, and the increase of efficiency. The Office also performs customer surveys that measure the public’s perceptions of the agency’s service delivery and provides insights for agency planning. The Office leads the development and maintenance of the quality assurance systems that support nationwide studies and reviews.
  2. Organization
    1. The Associate Commissioner for Quality Review (TQG)
    2. The Deputy Associate Commissioner for Quality Review (TQG)
    3. The Immediate Office of the Associate Commissioner for Quality Review (TQG)
    4. Division of Disability Quality (TQGA)
    5. Division of Review Automation Support (TQGB)
    6. Division of Title II Quality and Special Studies (TQGC)
    7. Division of Title XVI Quality and Service Evaluation (TQGE)
    8. The Field Site Operations – Baltimore (TQG-FA)
    9. The Field Site Operations – (TQG-F through TQG-FX)
  3. Functions
    1. The Associate Commissioner for Quality Review (OQR) (TQG) is directly responsible to the Deputy Commissioner for Analytics, Review, and Oversight to carry out OARO and OQR's mission and provide general supervision to the major components of OQR.
    2. The Deputy Associate Commissioner for OQR (TQG) assists the Associate Commissioner in carrying out his/her responsibilities and performing other duties as the Associate Commissioner may prescribe.
    3. The Immediate Office of the Associate Commissioner for OQR (TQG) provides the Associate Commissioner with staff assistance on the full range of his/her responsibilities.
    4. The Division of Disability Quality (TQGA) has overall responsibility for the design, development, coordination, analysis, and reporting on quality review and feedback at the initial, reconsideration, and hearing levels of disability adjudication, including the State and Federal disability determination components. Develops disability quality review policy and procedures; analyzes data to identify significant trends to determine their causes and costs, and to target areas needing study to determine corrective action. Uses improved quality selection models to ensure the validity of the data and to respond to disability program and quality review program changes. Conducts ad hoc analyses addressing specific issues and requests for disability-related information. Issues periodic reports related to all reviews.
    5. The Division of Review Automation Support (TQGB) provides headquarters and field components with systems design, requirements, maintenance, support, and training for the Electronic Quality Assurance (EQA), Business Intelligence Gateway (BIG—Hyperion), Disability Case Adjudication and Review System (DCARS), and Disability Quality Review (DQR) applications and databases. Maintains a Help Desk for handling user questions, requests, and issues; conducts periodic security/privilege reviews to verify user access; provides workload reports and other analytical data. Supports reviews conducted by OQR divisions.
    6. The Division of Title II Quality and Special Studies (TQGC) reviews, evaluates, and reports on the integrity and quality of the administration of Social Security’s Title II program and is responsible for studies of special workloads. Recommends corrective changes in programs, policies, procedures, or legislation aimed at quality and productivity based upon the results of the reviews. Conducts ongoing quality reviews and analyses of the non-medical aspects of the Title II program; provides support and guidance to quality assurance staff in the field; conducts quality reviews and special studies of the full range of legal requirements, policies, procedures, systems, and operations for the Title II program. Reports on the prescription drug (Medicare D) subsidy program, including the review of initial entitlements and redeterminations of eligibility to subsidies. Conducts ongoing quality reviews of the enumeration process in accordance with the agency’s performance measurement plan to assign Social Security numbers and issue Social Security cards accurately. Assesses the accuracy of the Numident as it relates to data matches from State and other Federal agencies and the Agency’s internal processes. Provides quality review feedback to operating components; transmits quality review data to appropriate parties; performs ad-hoc reviews as required.
    7. The Division of Title XVI Quality and Service Evaluation (TQGE) reviews, evaluates, and reports on the integrity and quality of the administration of the Title XVI program. Recommends corrective changes in programs, policies, procedures, or legislation aimed at quality and productivity improvement based upon the results of the reviews. Conducts quality reviews, special studies, and analyses of the full range of legal requirements, policies, procedures, systems, and operations for the non-medical aspects of the Title XVI program; provides support and guidance to program and integrity field staff; ensures proper case documentation; provides quality review feedback to operating components; and transmits quality review data to appropriate parties. Conducts an ongoing quality review of the agency’s telephone service, monitoring both the national 800 number and local field offices, to measure the accuracy and courtesy of incoming business calls. Performs customer surveys that measure the public’s perceptions of the agency’s service delivery. Provides insights for agency planning—evaluating both ongoing services and new agency initiatives.
    8. The Field Site Operations - Baltimore (TQG-FA) manages quality assurance and evaluation activities in Baltimore, MD. Conducts reviews to determine payment and eligibility error rates in Social Security programs, including errors in Federally-administered State supplementary payments. Conducts reviews to determine the quality of adjudication processes of Social Security programs. Provides reports, data, and analyses; identifies error trends and sources, and recommends corrective actions; and performs special assessment surveys and analyses.
    9. The Field Site Operations (TQG-F through TQG-FX) manages quality assurance and evaluation activities in the field. Conducts reviews to determine payment and eligibility error rates in Social Security programs, including errors in Federally-administered State supplementary payments. Conducts reviews to determine the quality of adjudication processes of Social Security programs. Provides reports, data, and analyses; identifies error trends and sources, and recommends corrective actions; and performs special assessment surveys and analyses. Acts as a liaison to regional counterparts.