Senior Auditor - Medicaid Fraud Control Unit

Legal/Office of Attorney General; United States; On-site; USD 85,000 - 120,000; Full time

Job summary

The Delaware Department of Justice seeks a Senior Auditor for the Medicaid Fraud Control Unit to provide auditing and data analysis expertise in civil and criminal health care fraud investigations. The role involves managing data mining programs, analyzing complex health care and financial data, detecting fraud patterns in Medicaid claims, and supporting multijurisdictional investigations.

The Senior Auditor will work collaboratively with investigators, prepare reports and trial exhibits, and

Qualifications

• Bachelor's degree in Economics, Finance, Business Management, CIS or related field.
• Three years designing analytical studies with defined goals, data sources, and sampling methods.
• Three years interpreting laws, rules, regulations, and policies.
• Proficiency in data analysis software such as Excel, Access, SQL, SAS, SPSS, Tableau, or SAP Business Objects.
• Experience collecting, analyzing, and formatting large data sets.
• Knowledge of Medicaid, Medicare, healthcare industry practices, GAAP, and statistical methods preferred.

Responsibilities

• Provide auditing and data analysis in civil and criminal health care fraud investigations.
• Manage data mining programs and analyze complex health care and financial data.
• Detect fraud patterns in Medicaid claims and support multi-jurisdictional investigations.
• Prepare reports and trial exhibits and coordinate with state Medicaid agencies and managed care organizations.

Skills

Data analysis

Analytical design

Statistical methods

Education

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

Tools

Excel

Access

SQL

SAS

SPSS

Tableau

SAP Business Objects

Job description

The Delaware Department of Justice seeks a Senior Auditor for the Medicaid Fraud Control Unit to provide auditing and data analysis expertise in civil and criminal health care fraud investigations. The role involves managing data mining programs, analyzing complex health care and financial data, detecting fraud patterns in Medicaid claims, and supporting multijurisdictional investigations. The Senior Auditor will work collaboratively with investigators, prepare reports and trial exhibits, and coordinate with state Medicaid agencies and managed care organizations.

Key qualifications:

• Bachelor's degree in Economics, Finance, Business Management, Computer Information Systems or related field
• Three years of experience designing analytical studies with defined goals, data sources, and sampling methods
• Three years of experience interpreting laws, rules, regulations, and policies
• Proficiency in data analysis software such as Excel, Access, SQL, SAS, SPSS, Tableau, or SAP Business Objects
• Experience collecting, analyzing, and formatting large data sets
• Knowledge of Medicaid, Medicare, healthcare industry practices, GAAP, and statistical methods preferred