OAG - Medicaid Fraud Control Unit | Compliance Analyst I-II |

Compliance Analyst I-II

The Medicaid Fraud Control Unit (MFCU) of the Office of the Attorney General (OAG) is seeking a Compliance Analyst. Work will involve conducting compliance analysis in-house work by researching and analyzing data-intensive information, reports, and records to identify evidence to support investigations of Medicaid violations. Applicants for this position should be prepared to pass a background investigation. Applicants will also be subject to a motor vehicle registration check and social media check. Since most security clearance problems arise from criminal records or unresolved bad credit issues, full criminal and credit checks will be run on all applicants prior to employment. Must possess a valid driver's license.

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 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

Compliance Analyst I: 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. 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. Provides support and collaborates in the planning, development, implementation, analysis, and documentation of preliminary investigations. Skill in effective oral and written communication. 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.

Compliance Analyst II – All of the above functions for a Compliance Analyst I, PLUS: Makes presentations to staff.

Qualifications

Minimum Qualifications Compliance Analyst I: Education: Graduation from high school or equivalent Education: Bachelor's degree from an accredited college or university; major coursework in business administration, public administration, finance, accounting, computer science, statistical analysis, mathematics, research methodology, criminal justice, or a related field is generally preferred. Experience and education may be substituted for one another. Experience: Two years of full-time experience (or closely related experience) in the following: 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 in research, compliance analysis or monitoring, legal analysis, and/or auditing work.

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 10%

Compliance Analyst II – All of the above qualifications for a Compliance Analyst I, PLUS: Experience: One additional year of full-time experience (or closely related experience) in the following: 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.

Preferred Qualifications Experience in researching Medicaid, Medicare, Healthcare 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 Knowledge of the Texas Medical Assistance Plan under Title XlX of the Social Security Act (Medicaid)