Public Benefits Fraud Analytics Investigator

Mass; Boston (MA); On-site; USD 61,000 - 92,000; Full time

Job summary

The Commonwealth of Massachusetts, Office of the State Auditor, is seeking a Data Analytic Fraud Examiner to investigate fraudulent claims and analyze Medicaid/EBT data to detect fraud, waste, or abuse. You will develop data models, run SQL queries, and present findings to management.

Preferred qualifications include 3+ years in investigations/analytics, experience with Medicaid data, and proficiency in SQL and BI tools (Tableau, QlikView). Full-time, on-site in multiple MA offices.

Qualifications

• At least three (3) years’ experience in investigations, research, analytics or related field.
• Experience in fraud investigations in public benefits or white-collar crimes preferred.
• Experience with Medicaid claims data or DTA data.
• Proficient in SQL and data visualization tools (Tableau, QlikView/Sense).
• Master’s degree or substantial related experience in investigations, auditing, data analysis.

Responsibilities

• Investigate fraudulent claims, transactions, and improper receipt of funds in public assistance programs.
• Analyze Medicaid/EBT and other transactional data to detect fraud.
• Develop data models and maintain data mining processes.
• Prepare written summaries and reports for management.
• Collaborate with BSI, Audit Operations, and IT to fulfill data analysis projects.

Skills

Investigations & analytics

SQL proficiency

Data visualization (Tableau, QlikView)

Fraud investigations experience

Education

Master’s degree in criminal justice / public policy

Professional fraud licensure/certification

Tools

Tableau

QlikView

Excel

Job description

The Commonwealth of Massachusetts, Office of the State Auditor, is seeking a Data Analytic Fraud Examiner to investigate fraudulent claims and analyze Medicaid/EBT data to detect fraud, waste, or abuse. You will develop data models, run SQL queries, and present findings to management.

Preferred qualifications include 3+ years in investigations/analytics, experience with Medicaid data, and proficiency in SQL and BI tools (Tableau, QlikView). Full-time, on-site in multiple MA offices.