Medicaid Program Integrity Investigator

My Florida CFO; Miami (FL); On-site; USD 44,000 - 54,000; Full time

Benefits offered by this job

Health insurance

Life insurance

Dental, vision

Retirement options

Paid time off

Holiday leaves

Job summary

The Agency for Health Care Administration in Florida seeks an Inspector Specialist to join the Bureau of Medicaid Program Integrity. You will conduct investigations, perform on-site visits, and prepare detailed investigative reports to support referrals and enforcement actions.

The ideal candidate has two years in investigative or health care enforcement, proficiency with Word/Excel/PowerPoint/Outlook, and the ability to work independently in a fast-paced environment.

Qualifications

• Two years of investigative, enforcement, health care, or professional experience in a regulatory/oversight setting.
• One year of planning, organizing, and coordinating work assignments.
• One year of professional use of Word, Excel, PowerPoint, and Outlook.
• Preference given to candidates with program integrity related professional certification.

Responsibilities

• Conduct investigations, visit providers, identify overpayments, and draft investigative summaries.
• Lead pre-audit preparations, prepayment reviews, and project initiatives per approved protocols.
• Collaborate with MPI units and regulatory agencies; participate in data-driven field initiatives.
• Perform on-site visits to determine Medicaid policy violations and document results.

Skills

Investigative skills

Data analysis

Research methods

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Communication skills

Education

Associate degree in health field

Tools

Word

Excel

PowerPoint

Outlook

Job description

The Agency for Health Care Administration in Florida seeks an Inspector Specialist to join the Bureau of Medicaid Program Integrity. You will conduct investigations, perform on-site visits, and prepare detailed investigative reports to support referrals and enforcement actions.

The ideal candidate has two years in investigative or health care enforcement, proficiency with Word/Excel/PowerPoint/Outlook, and the ability to work independently in a fast-paced environment.