Medicaid Fraud Analyst I/II

Pennsylvania Office of Attorney General; Harrisburg (Dauphin County); Hybrid; USD 47,000 - 61,000; Full time

Job summary

Pennsylvania Office of Attorney General in Harrisburg is seeking a Medicaid Fraud Analyst I/II to join the Medicaid Fraud Control Section. The role focuses on data retrieval, analysis, and support for investigations into Medicaid fraud and related regulations.

The position reports to an investigative supervisor and will work typical hours with telework options based on business needs. The role is full-time, non-civil service and unionized.

Qualifications

• Bachelor’s Degree from an accredited institution
• High school diploma plus four years of relevant experience
• Master’s Degree in criminal justice or related field (Analyst II)
• High school diploma plus six years of relevant experience
• Equivalent combination of education, training and experience

Responsibilities

• Assist with data retrieval, compilation and summarization for investigations
• Meet with personnel to determine data needs
• Request pertinent documents for analysis
• Prepare spreadsheets, charts and graphs
• Provide litigation support for official proceedings/court
• Testify in court and grand jury proceedings regarding analytical findings
• Enter data into computer systems
• Perform other duties as assigned

Skills

Microsoft Excel (advanced)

Pivot Tables

Oral and written communication

Independent and team work

Education

Bachelor's degree

High school diploma + 4 years experience

Master's degree in criminal justice or related field

High school diploma + 6 years experience

Equivalent education/experience

Job description

Section: Medicaid Fraud Control Section/Criminal Law Division

Class: Medicaid Fraud Analyst I/II

Location: Harrisburg

Telework: This position will report to the headquartered location a minimum of 2 days per week. You may have the opportunity to telework the remainder of the week, if desired and based on business need.

Position Type: Full-time, Non-civil service, Union

Work Hours: 8:30 – 5:00

Salary Range: Medicaid Fraud Analyst I - Pay Range 5: Starting salary $46,827

Medicaid Fraud Analyst II - Pay Range 7: Starting salary $60,538

Basic Function

An employee in this position performs work which involves the retrieval, analysis, and compilation of data and the verification and dissemination of information pertinent to investigations into the Medicaid Fraud and Abuse amendments, the Neglect of Care-Dependent Persons Act, and other applicable State and Federal regulations. The employee is responsible for assisting with/conducting the retrieval, compilation, and summarization of information needed by Special Agents in the course of an investigation. Supervision is received from an investigative or administrative superior who reviews the work while in progress and upon completion.

• Assists with determining,or determines under the direction andguidance ofan experiencedanalystand/or supervisor, data requirements, sources, and parameters andgathers the neededinformation within the given time constraints usinga varietyof methods, inclusive of variouscomputer programs
• Meets with appropriate personnel within the OAGor othergovernmental agencies toascertainneeds with respect to assignments
• Makes requests forpertinent documents needed fortheanalysis of referrals/intake complaints or pendinginformation
• Contacts individuals to schedule meetings, and participates inthe meetings, in order togatherneeded data
• Assists with the preparation of, or prepares under the direction andguidance of an experiencedanalystand/or supervisor, summarizations of data gathered byediting, compiling, and tabulating
• Provides assistance to agents relative to datachecks, background checks,and claims histories
• Assists with the execution of search warrants for thepurposeofcataloging data and documentaryevidence
• Assists with the conduct of, or conducts under the direction andguidance ofan experiencedanalystand/or supervisor, various surveys of limited scope when anassignment requires suchand prepares reports of findings
• Prepares spreadsheets, charts, andgraphs
• Assists with the review of, or reviews under the direction andguidance ofan experienced analystand/or supervisor,computer printouts, vouchers, or other documents to ascertain the needed data
• Provides litigation support throughthe preparation and presentation of material/evidence forofficial proceedings/court
• Testifies in court proceedings andgrand juryproceedings regarding analytical findings.Inputs data into computer system byutilizing a computer keyboard
• Performs other duties as assigned

Qualifications for Medicaid Fraud Analyst I are as follows:

• A Bachelor’sDegree from an accredited institution OR
• Graduation from high school and fouryears of relevant experience that would afford theindividual the needed knowledge and skills to perform the job OR
• Anyequivalent combination of education, training, and experience that would enable theindividual to perform theduties of the job

Qualifications for Medicaid Fraud Analyst II are as follows:

• A Bachelor’sDegreefrom an accredited institutionand twoyears ofrelevant experiencethatwould afford theindividual the needed knowledgeand skills to perform thejob OR
• A Master’s Degree in criminal justice or a relatedfield OR
• Graduation from high school and sixyears of relevant experience that would afford theindividual theneeded knowledge and skills to perform the job OR
• Any equivalent combination of education, training and experience that would enable the individual to perform the duties of the job

• Knowledge of Microsoft Excel (advanced)
• Experience using Pivot Tables
• Possess excellent oral and written communication skills and be able to communicate with employees throughout all levels of the organization
• Ability to work both independently and in a team environment