Senior Auditor: Medicaid Fraud Analytics (Remote)

Delaware LLC; Dover (DE); Hybride; USD 70 000 - 95 000; Plein temps

Avantages offerts par ce poste

Loan forgiveness

Healthcare plan

Pension plan

Vacation leave

Parental leave

Résumé du poste

Delaware Department of Justice seeks a Senior Auditor to support the Medicaid Fraud Control Unit in the Fraud & Consumer Protection Division. The role focuses on auditing and data analysis for civil and criminal health care fraud investigations, including multijurisdictional qui tam matters, with teamwork and ability to work independently.

The Senior Auditor will compile evidence, summarize restitution calculations, and contribute to policy recommendations while coordinating with the state

Qualifications

• Bachelor-level or higher in a related field.
• At least three years designing analytical studies and determining study goals, data sources, and sampling methods.
• At least three years interpreting laws, rules and procedures.
• Ability to plan, prioritize, organize and problem solve.
• Ability to analyze data and make sound recommendations.
• Experience using data analytics software (Excel, SQL, Tableau, SAS, SPSS).
• Experience in narrativ e report writing.

Responsabilités

• Manage the unit’s data mining program and coordinate with state Medicaid agency.
• Perform database queries to extract claims and data for investigations.
• Analyze varied health care and financial data.
• Identify evidence of fraud through trends and patterns.
• Prepare written reports and present findings to the investigative team.
• Prepare trial exhibits and testify as needed.
• Make program and policy recommendations.

Connaissances

Healthcare analytics

Data mining

GAAP knowledge

Statistical analysis

Data visualization

Formation

Bachelor’s degree or higher in Economics, Finance, Business Management, Computer Information Systems or related field

Outils

Excel

SQL

Tableau

SAS/SPSS

Description du poste

Delaware Department of Justice seeks a Senior Auditor to support the Medicaid Fraud Control Unit in the Fraud & Consumer Protection Division. The role focuses on auditing and data analysis for civil and criminal health care fraud investigations, including multijurisdictional qui tam matters, with teamwork and ability to work independently.

The Senior Auditor will compile evidence, summarize restitution calculations, and contribute to policy recommendations while coordinating with the state