Medicaid Fraud Analyst II – 41001293 | Florida Department of Transportation

 
 

Requisition No: 406123
Agency: Office of the Attorney General
Working Title: MEDICAID FRAUD ANALYST II – 41001293
Position Number: 41001293
Salary: $32,697 – $37,000
Posting Closing Date: 07/09/2021
This is a Full-Time Position
VETERAN’S PREFERENCE
Persons applying claiming veteran’s preference eligibility for this position must complete (in its entirety) in People First and attach to their application in People First the following: 1.) Veteran’s Preference Certification form 2.) Supporting Documentation for Category you are claiming. FAILURE TO COMPLETE AND ATTACH THE NECESSARY FORM AND SUPPORTING DOCUMENTATION BY THE CLOSE OF THE VACANCY ANNOUNCEMENT WILL RESULT IN VETERAN’S PREFERENCE NOT BEING APPLIED. You will need to: 1) print these forms, 2) manually complete the forms, 3) scan the completed forms, 4) save the completed forms, then 5) attach the completed forms to your profile in People First.
If you are having trouble attaching your completed forms to your profile contact our HR office at 850-414-3900.
INTRODUCTORY STATEMENT: The Office of the Attorney General, Department of Legal Affairs (OAG) is a pre-eminent, constitutional office, which serves as the chief lawyer to all state agencies and provides legal protections for Floridians against fraud and through the enforcement of the state’s laws. The OAG, is a cabinet agency in the executive branch of Florida state government.
IMPORTANT NOTICE: To be considered for the position all applicants must:
Submit a complete and accurate application profile necessary for qualifying, such as dates of service, reason for leaving, etc. In addition, all applicants must ensure all employment and/or detailed information about work experience is listed on your application (including military service, self-employment, job-related volunteer work, internships, etc.) and that gaps in employment are explained. Applicants who do not provide all information necessary to qualify, will not be considered for this position.
Verify 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.
The elements of the selection process may include a skill assessment exercise.
Current and future vacancies may be filled from this advertisement for a period of up to six months. Following the six-month period, a new application must be submitted to an open advertisement to be considered for that vacancy.
OAG employees are paid biweekly. All state employees are required to participate in the direct deposit program pursuant to s. 110.113 Florida Statutes.
MINIMUM REQUIREMENTS: A bachelor’s degree from an accredited college or university and one year of professional experience in research, investigations, investigative analysis or statistics. Professional or nonprofessional experience as described above can substitute on a year-for-year basis for the required college education.
Preference will be given to candidates who have experience compiling and analyzing investigative information; and experience in the use of spreadsheets and relational database applications.
SKILLS VERIFICATION TEST 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.
JOB SUMMARY: This position is in the Medicaid Fraud Control Unit.


Ksa/Examples Of Work Performed


An employee in this position provides analytical support for attorneys and investigators in Florida-specific and multistate health care fraud investigations and litigation matters. An employee in this position also 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. An employee in this position may also perform as lead analyst on specialized complex civil enforcement investigations and litigation matters and analytical projects.
35 % Create customized downloads from on-line Medicaid claims data warehouse as requested by investigators, attorneys, and multistate investigative and litigation teams.
25 % Prepare reports/schedules/charts pertaining to all aspects of the analysis and research for use in criminal prosecution, civil actions and administrative referrals.
20 % 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.
10 % Extract information from investigative databases. Compile, analyze and disseminate intelligence information retrieved from various computer databases/systems. Perform various duties related to computers.
5 % Assist in the prosecution of Medicaid fraud and/or patient abuse to include testimony in courts of law pertaining to the investigation.
5 % Other duties as assigned.
OTHER REQUIREMENTS: Experience in compiling and analyzing investigative information to include financial and/or statistical data. Experience in creating reports based on information analyzed for use in criminal, civil, and administrative proceedings. Must have strong computer knowledge in the use of spreadsheet and data base applications.
VETERAN RECRUITMENT STATEMENT: The OAG values the service provided by veterans and their families and supports the hiring of returning service members and military spouses. Applicants eligible for veterans’ preference will receive preference in employment and are encouraged to apply, pursuant to chapter 295, Florida statutes. However, applicants claiming veterans’ preference must attach supporting documentation with each application submission that includes character of service (for example, dd form214 member copy #4) along with any other documentation as required by rule 55a-7, Florida administrative code. All documentation is due by the closing date of the vacancy announcement. For information on the supporting documentation required, click here . If you have trouble attaching the documentation, contact our HR office at 850-414-3900.
PERSONS WITH DISABILITY/ADA STATEMENT: The OAG supports the employment of individuals with disabilities and encourages them to seek employment within our agency. If you need an accommodation because of a disability, as defined by the Americans with Disabilities Act, in order to participate in the application process, please notify the people first service center at 877-562-7287. If you need accommodation during the selection process, please notify the hiring authority in advance to allow sufficient time to provide the accommodation.
CRIMINAL BACKGROUND CHECKS/ DRUG FREE WORKPLACE: All OAG positions are “sensitive or special trust” and require favorable results on a background investigation including fingerprinting, pursuant to s. 110.1127(2)(a), F.S. The State of Florida supports a Drug-Free Workplace, all employees are subject to reasonable suspicion or other drug testing in accordance with section 112.0455, F.S., Drug-Free Workplace Act.
We hire only U.S. citizens and those lawfully authorized to work in the U.S.
E-VERIFY STATEMENT: The Office of the Attorney General participates in the u.s. government’s employment eligibility verification program (e-verify). E-verify is a program that electronically confirms an employee’s eligibility to work in the united states after completion of the employment eligibility verification form (i-9).
REMINDERS: Male applicants born on or after October 1, 1962, will not be eligible for hire or promotion unless they are registered with the Selective Services System (SSS) before their 26th birthday, or have a Letter of Registration Exemption from SSS. For more information, please visit the SSS website at: https: //www.sss.gov.
If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. Your current retirement benefits may be canceled, suspended or deemed ineligible depending upon the date of your retirement.
The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.
Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.
The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.
VETERANS’ PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans’ Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.
Nearest Major Market: Orlando

 
 

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