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Medicaid Fraud Inspector Jobs in Chicago, IL (NOW HIRING)

Medicaid Fraud Inspector information

What are some common challenges faced by a Medicaid Fraud Inspector, and how can they be addressed?

Medicaid Fraud Inspectors often encounter challenges such as navigating complex healthcare regulations, analyzing large volumes of data, and dealing with uncooperative individuals during investigations. Staying current with ever-evolving policies and maintaining attention to detail are crucial for success in this role. Collaborating closely with legal teams, healthcare providers, and law enforcement helps address these challenges and ensures thorough investigations. Ongoing professional development and training in investigative techniques can also support inspectors in overcoming these obstacles.

What does a Medicaid Fraud Inspector do?

A Medicaid Fraud Inspector investigates allegations of fraud, waste, and abuse within the Medicaid program. Their responsibilities include reviewing claims, gathering evidence, interviewing witnesses, and collaborating with law enforcement agencies to identify and stop fraudulent activities. They help ensure that Medicaid funds are used appropriately and that providers and recipients comply with all relevant laws and regulations. By preventing fraud, they protect both taxpayers and vulnerable populations who rely on Medicaid services.

What are the key skills and qualifications needed to thrive as a Medicaid Fraud Inspector?

To thrive as a Medicaid Fraud Inspector, you need a strong background in criminal justice, finance, or healthcare, often supported by a relevant degree and investigative experience. Familiarity with data analysis software, case management systems, and knowledge of Medicaid regulations and fraud detection techniques is essential. Attention to detail, critical thinking, and strong communication skills help inspectors effectively analyze evidence and coordinate with law enforcement agencies. These skills ensure accurate identification, investigation, and prevention of fraudulent activities to protect public funds and maintain program integrity.

What is the difference between Medicaid Fraud Inspector vs Medicaid Investigator?

AspectMedicaid Fraud InspectorMedicaid Investigator
CredentialsTypically requires certifications like CFE or CPAOften requires similar certifications, sometimes with additional law enforcement credentials
Work EnvironmentGovernment agencies, healthcare compliance departmentsLaw enforcement agencies, government offices
Employer & IndustryState Medicaid agencies, healthcare organizationsState or federal law enforcement, Medicaid fraud units
Search & Comparison IntentHigh overlap in fraud detection and compliance rolesFocuses more on investigation and enforcement actions

Medicaid Fraud Inspectors primarily focus on auditing and detecting fraud within Medicaid programs, often working in compliance roles. Medicaid Investigators tend to conduct in-depth investigations, often with law enforcement authority. Both roles require similar credentials and work within government or healthcare settings, but their core functions differ in scope and enforcement authority.

What are popular job titles related to Medicaid Fraud Inspector jobs in Chicago, IL? For Medicaid Fraud Inspector jobs in Chicago, IL, the most frequently searched job titles are:
What job categories do people searching Medicaid Fraud Inspector jobs in Chicago, IL look for? The top searched job categories for Medicaid Fraud Inspector jobs in Chicago, IL are:

Attorney - FCA/Healthcare Fraud Enforcement

Jobot

Chicago, IL

$150K - $400K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 15 days ago


Job description

This Jobot Job is hosted by: Forrest Mack
Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.
Salary: $150,000 - $400,000 per year
A bit about us:
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A nationally recognized law firm with deep roots in the healthcare industry, the firm has built a reputation for advising clients on some of the most complex regulatory, litigation, transactional, and compliance matters in the market. Its attorneys represent healthcare providers, health plans, life sciences companies, private equity sponsors, and other industry leaders across a broad range of legal disciplines. Known for its collaborative culture and industry-focused approach, the firm combines sophisticated legal counsel with practical business insight to help clients navigate evolving regulatory environments and high-stakes business challenges. The firm has earned national recognition for its strength in healthcare, government investigations, litigation, corporate transactions, and regulatory counseling, making it a trusted advisor to organizations operating in highly regulated industries.
Why join us?
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Employment Benefits
  • Competitive partner compensation structure based on experience, practice contributions, and portable business.
  • Origination credit and business development incentives.
  • Comprehensive medical, dental, and vision insurance.
  • Health Savings Account (HSA) and Flexible Spending Account (FSA) options.
  • 401(k) retirement plan with firm contributions.
  • Life and disability insurance.
  • Generous paid time off and firm-recognized holidays.
  • Paid parental leave and family support benefits.
  • Employee assistance and wellness programs.
  • Professional development, CLE, and bar membership reimbursement.
  • Business development and marketing support.
  • Access to a nationally recognized healthcare, litigation, and regulatory platform.
  • Cross-selling opportunities across healthcare, private equity, litigation, compliance, and corporate practices.
  • Administrative, paralegal, and practice support resources.
  • Opportunities for leadership, mentorship, and practice growth.
  • Hybrid work flexibility, subject to client and business needs.
  • Collaborative, entrepreneurial culture with significant opportunities for advancement.

Job Details
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Qualifications
  • Juris Doctor (J.D.) from an accredited law school.
  • Active membership in good standing with at least one U.S. state bar, Illinois admission preferred or ability to obtain admission.
  • 8+ years of experience representing healthcare organizations, health plans, managed care organizations, healthcare providers, life sciences companies, or other regulated entities in government investigations, enforcement actions, and complex litigation matters.
  • Significant experience handling False Claims Act (FCA) investigations, qui tam litigation, Civil Investigative Demands (CIDs), healthcare fraud matters, and government enforcement proceedings.
  • Demonstrated experience representing clients before the U.S. Department of Justice (DOJ), U.S. Attorney's Offices, Department of Health and Human Services Office of Inspector General (HHS-OIG), Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, and other federal or state enforcement authorities.
  • Experience conducting internal investigations involving fraud and abuse allegations, reimbursement disputes, billing and coding issues, Anti-Kickback Statute matters, Stark Law compliance, and other healthcare regulatory concerns.
  • Strong litigation background with experience managing all phases of complex commercial, regulatory, or healthcare litigation, including discovery, motion practice, witness preparation, settlement negotiations, and trial strategy.
  • Demonstrated ability to independently manage sophisticated client matters while serving as a trusted advisor to executive leadership teams, boards, and healthcare stakeholders.
  • Proven business development skills and a track record of cultivating and expanding client relationships within the healthcare industry.
  • Portable book of business preferred for partner-level candidates.
  • Excellent written advocacy, oral advocacy, negotiation, and client counseling skills.
  • Ability to collaborate across multidisciplinary legal teams in a fast-paced, client-focused environment.

Preferred Qualifications
  • Former Assistant United States Attorney (AUSA), Department of Justice attorney, HHS-OIG attorney, CMS attorney, or other government enforcement experience.
  • Experience representing hospitals, health systems, physician groups, Medicare Advantage organizations, managed care organizations, pharmacy benefit managers (PBMs), healthcare technology companies, or private equity-backed healthcare platforms.
  • Experience litigating Administrative Procedure Act (APA) challenges involving federal healthcare agencies.
  • Experience handling Medicare Advantage Star Ratings litigation, CMS reimbursement disputes, risk adjustment matters, RADV audits, Medicare payment disputes, or other healthcare regulatory litigation.
  • Experience defending healthcare clients in high-profile government investigations involving alleged fraud, waste, abuse, reimbursement, or compliance issues.
  • Established relationships within the healthcare, managed care, government enforcement, or healthcare regulatory sectors.

Demonstrated leadership experience mentoring attorneys and contributing to practice growth initiatives.
  • Existing network of referral sources, industry contacts, and healthcare executives.

Interested in hearing more? Easy Apply now by clicking the "Apply Now" button.
Jobot is an Equal Opportunity Employer. We provide an inclusive work environment that celebrates diversity and all qualified candidates receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. Jobot also prohibits harassment of applicants or employees based on any of these protected categories. It is Jobot’s policy to comply with all applicable federal, state and local laws respecting consideration of unemployment status in making hiring decisions.
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About Jobot

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Jobot is a revolutionary Recruiting Rirm that combines the latest in AI technology with our custom software, Jax, and partners it with Jobot Pros experienced recruiters to fill jobs and provide incredible service to our clients and candidates in the process. We are disrupting the Recruiting space and have grown from 0 to over 750 folks in 5 years. Jobot is committed to workplace flexibility. Come join us at the beautiful Jobot House in Newport Beach, CA or work from anywhere in the United States with strong WiFi. We have recruiters in New York, Hawaii and all over the US. We typically fly top performers to California a few times a year to enjoy the weather and celebrate in style.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Irvine, CA, US

Year founded

2018