MEDICAID FRAUD ANALYST II - 41001204

State of Florida • Tampa, FL

6d • Onsite

About The Position

This Medicaid Fraud Analyst II position is in the Office of the Attorney General withing the Medicaid Fraud Control Unit in Tampa, Florida. The Office represents the State of Florida in state and federal civil and criminal courts, from trial courts to the Supreme Court of the United States.

Requirements

• Five (5) years of experience in research, investigations, investigative analysis or statistics; or
• A Bachelor degree from an accredited college or university and one (1) year of professional experience in research, investigations, investigative analysis or statistics.
• All applicants who meet the screening criteria/minimum job requirements will be required to take a timed Skills Verification Test. Applicants must receive a score of at least 70% to move to the interview phase.
• Candidate Profile (application) must be completed in its entirety.
• Include supervisor names and phone numbers for all periods of employment.
• Account for and explain any gaps in employment so that the hiring process is not delayed.
• Experience, education, training, knowledge, skills and/or abilities as well as responses to pre-qualifying questions must be verifiable to meet the minimum qualifications.
• It is unacceptable to use the statement “See Resume” in place of entering work history.
• All applicants must ensure all employment and/or detailed information about work experience is listed on the application (including military service, self-employment, job-related volunteer work, internships, etc.) and that gaps in employment are explained.
• Ensure that applicant responses to qualifying questions are verifiable by skills and/or experience stated on the employment application and/or resume.
• Applicants who do not respond to the qualifying questions will not be considered for this position.
• Male applicants born on or after October 1, 1962, will not be eligible for hire or promotion unless they are registered with the Selective Service System (SSS) before their 26th birthday, or have a Letter of Registration Exemption from SSS.

Nice To Haves

• Experience compiling and analyzing investigative information
• Experience in the use of spreadsheets and relational database applications.

Responsibilities

• Provides analytical support for attorneys and investigators in Florida-specific and multistate health care fraud investigations and litigation matters.
• Performs work conducting detailed research and analysis of investigative information relating to alleged violations of applicable laws pertaining to health care fraud, in the administration of the Medicaid program, and/or the alleged abuse or neglect of patients in health care facilities governed by the State Medicaid program.
• May perform as lead analyst on specialized complex civil enforcement investigations and litigation matters and analytical projects.
• Designs and writes new EDW ad hoc reports and queries.
• Serves as a MFCU analyst providing EDW support throughout the MFCU.
• Serves as an instructor on the new EDW to the various MFCU regional offices, in support of Operations & Management Consultant I and Operations & Management Consultant II.
• Creates customized downloads from on-line Medicaid claims data warehouse as requested by investigators, attorneys, and multistate investigative and litigation teams.
• Prepares reports/schedules/charts pertaining to all aspects of the analysis and research for use in criminal prosecution, civil actions and administrative referrals.
• Assists and supports Medicaid fraud investigators and attorneys in the compilation and analysis of investigative information and the development of damages models for use in Florida-specific and multistate health care fraud investigations and litigation.
• Obtains and analyzes large amounts of data to interpret and summarize health care fraud activity, calculate damages sustained to the Florida Medicaid program, determine significance, completeness and usefulness of data, recognize and identify patterns and trends, and brief investigators and attorneys.
• Extracts information from investigative databases.
• Compiles, analyzes and disseminates intelligence information retrieved from various computer databases/systems.
• Performs various duties related to computers.
• Assists in the prosecution of Medicaid fraud and/or patient abuse to include testimony in courts of law pertaining to the investigation.
• Other duties as assigned.

Benefits

• Annual and Sick Leave benefits.
• Nine paid holidays and one Personal Holiday each year.
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options.
• Retirement plan options, including employer contributions.
• Flexible Spending Accounts
• Tuition waivers.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level