Senior Fraud and Waste Investigator, Medicaid

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The Senior Fraud and Waste Professional, Medicaid conducts investigations of allegations of fraudulent and abusive practices. The Senior Fraud and Waste Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Fraud and Waste Professional, Medicaid coordinates investigation with law enforcement authorities. Assemble evidence and documentation to support successful adjudication, where appropriate. Conduct on-site audits of provider records ensuring appropriateness of billing practices. Prepare complex investigative and audit reports. Begin to influence department's strategy. Make decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercise considerable latitude in determining objectives and approaches to assignments.<...