MEDICAID FRAUD ANALYST II

Requisition No: 825165

Agency: Office of the Attorney General

Working Title: MEDICAID FRAUD ANALYST II - 41001302 (WPB or TLH)

Pay Plan: Career Service

Position Number: 41001302

Salary: $55,000 Annually

Posting Closing Date: 03/27/2024

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** This position may be filled in West Palm Beach or Tallahassee **

Our Organization and Mission: 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.

Pay: $55,000 Annually

Position Summary: This position is in the Medicaid Fraud Unit. The incumbent in this position provides analytical support for attorneys and investigators in Florida-specific and multistate healthcare fraud investigations and litigation matters. The incumbent also performs work conducting detailed research and analysis of investigative information relating to alleged violations of applicable laws pertaining to healthcare fraud, in the administration of the Medicaid program, and/or the alleged abuse or neglect of patients in healthcare facilities governed by the State Medicaid program. In addition, the incumbent may also perform as the lead analyst on specialized complex civil enforcement investigations and litigation matters, and analytical projects.

Qualifications: 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, or 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.

The Work You Will Do: The responsibilities of this position include, but are not limited to the following:

• 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 healthcare fraud investigations and litigation. Obtains and analyzes large amounts of data to interpret and summarize healthcare 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 including 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 database applications.

The Benefits of Working for the State of Florida: Working for the State of Florida is more than a paycheck. The State’s total compensation package for employees features a highly competitive set of employee benefits including:

• 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 option.
• Retirement plan options, including employer contributions (For more information, please click www.myfrs.com).
• Flexible Spending Accounts
• Tuition waivers.
• And more! For a more complete list of benefits, visit www.mybenefits.myflorida.com.

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 the application (including military service, self-employment, job-related volunteer work, internships, etc.) and that gaps in employment are explained. NOTE: Any required experience and/or preferences listed in the advertisement must be verified at the time of application.

• 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.
• 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, FS.

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).

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 an accommodation during the selection process, please notify the hiring authority in advance to allow sufficient time to provide an accommodation.

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 Service 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. If you return to FRS employment before satisfying the required waiting period, your retirement may be voided, and you may have to repay all benefits you have received, including any Deferred Retirement Option Program (DROP) payout.

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. Certain service members may be eligible to receive waivers for postsecondary educational requirements. 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.