Senior Auditor, Health Care Fraud & Data Analytics (Hybrid)

Delaware LLC; Delaware; On-site; USD 70,000 - 110,000; Full time

Benefits offered by this job

Loan forgiveness

Healthcare plan

Pension plan

Vacation

Sick leave

Parental leave

Job summary

The Delaware Department of Justice is seeking a Senior Auditor to join the Medicaid Fraud Control Unit (MFCU) within the Fraud & Consumer Protection Division in the New Castle County office. The role focuses on auditing and data analysis for civil and criminal health care fraud investigations.

The Senior Auditor will collaborate with investigators on multijurisdictional qui tam cases, compile evidence of fraudulent activity, and present findings.

Qualifications

• Bachelor's degree or higher in Economics, Finance, Business Management, Computer Information Systems or related field.
• Three years of experience designing analytical studies (goals, data sources, sampling).
• Three years of experience interpreting laws, rules, regulations, standards, policies, procedures.

Responsibilities

• Manage the unit’s data mining program including proposals, development, analysis, and ROI tracking.
• Perform database queries to extract claims records and data for investigations.
• Analyze varied health care and financial data to detect fraud patterns.
• Summarize data using tables, charts, and graphs; prepare restitution and damage calculations.
• Prepare written reports and present findings to the investigative team.
• Coordinate with Medicaid agency and MCOs on policy and information requests.
• Provide technical expertise to multijurisdictional teams on Medicaid claims and databases.

Skills

Data analysis

SQL

Excel

SAS

Tableau

Education

Bachelor's degree or higher in Economics, Finance, Business Management, Computer Information Systems

Tools

Microsoft Excel

Microsoft Access

SAP Business Objects

Tableau

Cognos

SAS

SPSS

SQL

Job description

The Delaware Department of Justice is seeking a Senior Auditor to join the Medicaid Fraud Control Unit (MFCU) within the Fraud & Consumer Protection Division in the New Castle County office. The role focuses on auditing and data analysis for civil and criminal health care fraud investigations.

The Senior Auditor will collaborate with investigators on multijurisdictional qui tam cases, compile evidence of fraudulent activity, and present findings.