This position is responsible for the full range of professional audits for Department of Health and Human Services long term care providers under prior, current, and future methods of reimbursement. The position is responsible for insuring, through audit, that costs and/or statistical data claimed for reimbursement are allowable and appropriate according to federal and state laws or regulations, applicable state plans for Medical Assistance and Department Policy. The work requires utilization of the laws, regulations, rules, standards, policies, and procedures of professional auditing. Typically, the audits will involve nursing homes, hospitals, and county medical care facilities. This position functions as a senior level auditor in the Department of Health and Human Services-LTC Reimbursement and Audit Division, Grand Rapids Region. The employee in this position is responsible for performing the most complex on-site or in-house audits, reviews of nursing homes, hospitals, county medical care facilities, health maintenance organizations, and public health programs under current and future methods of reimbursement. This position conducts audit assignments, frequently serving as the lead auditor for complex facilities. The purpose is to satisfy the federal mandate for auditing Medicaid Providers and to ensure that the provider's reimbursement is in accordance with the rules and regulations governing the State Medicaid Reimbursement Programs and Procedures. The work requires the utilization of the laws, regulations, rules, standards, policies and procedures of professional auditing.
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Job Type
Full-time
Career Level
Mid Level