OAG - Medicaid Fraud Control Unit | Program Specialist II | 24-0620
Austin, Texas
Employer: CAPPS
Industry: Business and Financial Operations
Salary: Competitive
Job type: Full-Time
Job Description
REVISED 08/27/2024
GENERAL DESCRIPTION
The Medicaid Fraud Control Unit Division of the Office of the Attorney General (OAG) is seeking a Program Specialist that performs moderately complex primarily in-house investigative work by researching and analyzing data-intensive information, reports, and records to identify evidence to support investigation and prosecution of Medicaid fraud violations and physical and financial abuse in Medicaid-funded facilities.
The OAG is a dynamic state agency with over 4,000 employees throughout the State of Texas. As the State's law firm, the OAG provides exemplary legal representation in diverse areas of law. OAG employees enjoy excellent benefits (https://ers.texas.gov/Benefits-at-a-Glance) along with tremendous opportunities to do important work at a large, dynamic state agency making a positive difference in the lives of Texans.
ESSENTIAL POSITION FUNCTIONS
Qualifications:
MINIMUM QUALIFICATIONS
PREFERRED QUALIFICATIONS
TO APPLY
To apply for a job with the OAG, electronic applications can be submitted through CAPPS Recruit. A State of Texas application must be completed to be considered, and paper applications are not accepted. Your application for this position may subject you to a criminal background check pursuant to the Texas Government Code. Military Crosswalk information can be accessed at
https://hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_ProgramManagement.pdf
THE OAG IS AN EQUAL OPPORTUNITY EMPLOYER
REVISED 08/27/2024
GENERAL DESCRIPTION
The Medicaid Fraud Control Unit Division of the Office of the Attorney General (OAG) is seeking a Program Specialist that performs moderately complex primarily in-house investigative work by researching and analyzing data-intensive information, reports, and records to identify evidence to support investigation and prosecution of Medicaid fraud violations and physical and financial abuse in Medicaid-funded facilities.
The OAG is a dynamic state agency with over 4,000 employees throughout the State of Texas. As the State's law firm, the OAG provides exemplary legal representation in diverse areas of law. OAG employees enjoy excellent benefits (https://ers.texas.gov/Benefits-at-a-Glance) along with tremendous opportunities to do important work at a large, dynamic state agency making a positive difference in the lives of Texans.
ESSENTIAL POSITION FUNCTIONS
- Performs in-house investigative work by obtaining and analyzing information, data, and evidence from a variety of sources associated with allegations of fraud in the administration of the Medicaid program, fraud committed by Medicaid providers, and abuse, neglect and exploitation occurring in facilities that receive Medicaid funds and other facilities that provide nursing or personal care services
- Makes recommendations on the disposition of investigative findings by preparing detailed written analysis and reports in a professional, correct, and timely manner, consistent with MFCU guidelines
- Establishes and maintains liaison with outside agencies, associations, groups, and the like whose assistance and cooperation can enhance the mission of the MFCU, including but not limited to proactive generation of investigative targets
- Performs related work as assigned
- Maintains relevant knowledge necessary to perform essential job functions
- Attends work regularly in compliance with agreed-upon work schedule
- Ensures security and confidentiality of sensitive and/or protected information
- Complies with all agency policies and procedures, including those pertaining to ethics and integrity
Qualifications:
MINIMUM QUALIFICATIONS
- Education: Graduation from high school or equivalent
- Education: Bachelor's degree from an accredited college or university; experience in the following (or closely related) fields may be substituted for the required education on a year-for-year basis: full-time researching and compiling data, data extraction/query and analysis, using statistical methods and relational databases to analyze data sets, Medicaid, Medicare, healthcare insurance, white-collar crime investigations
- Experience: Three years full-time experience researching and compiling data, data extraction/query and analysis, using statistical methods and relational databases to analyze data sets, Medicaid, Medicare, healthcare insurance, white-collar crime investigations, or closely related experience
- Skill in researching and interpreting complex rules and regulations
- Skill in learning new or changing computer systems and databases
- Skill in writing and producing concise, professional quality documents and reports
- Skill in establishing and maintaining effective working relationship with management and co-workers
- Skill in working cooperatively in a team environment
- Skill in using spreadsheet applications in a Windows environment
- Skill in prioritizing tasks and working under time constraints
- Skill in using a computer for word-processing and data entry/retrieval
- Skill in handling multiple tasks, prioritizing, and meeting deadlines
- Skill in effective oral and written communication
- Skill in exercising sound judgment and effective decision making
- Ability to receive and respond positively to constructive feedback
- Ability to work cooperatively with others in a professional office environment
- Ability to provide excellent customer service
- Ability to work in person at assigned OAG work location, perform all assigned tasks at designated OAG work space within OAG work location, and perform in-person work with coworkers (e.g., collaborating, training, mentoring) for the entirety of every work week (unless on approved leave)
- Ability to arrange for personal transportation for business-related travel
- Ability to work more than 40 hours as needed and in compliance with the FLSA
- Ability to lift and relocate 30 lbs.
- Ability to travel (including overnight travel) up to 5%
PREFERRED QUALIFICATIONS
- Knowledge of the Texas Medical Assistance Plan under Title XlX of the Social Security Act (Medicaid)
- Experience in researching Medicaid program rules and regulations
- Experience performing intake duties
- Experience conducting preliminary investigations of complaints
- Experience as a business analyst, investigative analyst, intelligence analyst or closely related experience
- Experience with Texas Medicaid databases
- Experience with Business Objects, Microsoft Word, Excel, Access, and Outlook
TO APPLY
To apply for a job with the OAG, electronic applications can be submitted through CAPPS Recruit. A State of Texas application must be completed to be considered, and paper applications are not accepted. Your application for this position may subject you to a criminal background check pursuant to the Texas Government Code. Military Crosswalk information can be accessed at
https://hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_ProgramManagement.pdf
THE OAG IS AN EQUAL OPPORTUNITY EMPLOYER
Created: 2024-08-30
Reference: 00044766
Country: United States
State: Texas
City: Austin
ZIP: 78749
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