Medicaid Program Integrity Jobs in Wisconsin (NOW HIRING)

Introduction

The Department of Health Services (DHS), Office of the Inspector General (OIG) is recruiting to fill the Program Integrity and Compliance (PICS) Unit Supervisor position. This position has a flexible schedule and will primarily work Monday-Friday with daytime hours, with minimal statewide and overnight travel required. This position has the ability to work remotely up to 5 days per week and will be headquartered at the Madison, Milwaukee, or Waukesha state office building. This schedule may vary based on training or operational need. The OIG reports directly to the DHS Secretary and is charged with protecting the people of Wisconsin by preventing, detecting, and investigating fraud, abuse, and waste of public assistance programs such as Medicaid, FoodShare, WIC, IRIS, and FamilyCare. As an employee of the State of Wisconsin, you'll also have access to an amazing benefits package, including:

• 3.5 weeks of vacation, 9 paid holidays and ample sick time; limitations may apply for leave time usage in the first six months.
• Top rated health plan options starting at $47/month for single plans and $117/month for family plans, after 2 months of state service.
• Exceptional pension plan with a 7.25% employer match in 2027 with lifetime retirement payment. Plus, a tax advantaged supplemental retirement savings plan which allows you to save money directly from your paycheck for retirement. Use this Total Rewards Calculator to see the total value of our competitive benefits package!
• Several flex spending accounts: medical, dependent care, commuter, parking and High Deductible Health Savings.
• Well Wisconsin Wellness Program.
• A free and confidential employee assistance program that offers employees and their immediate family dependents a variety of tools, resources, and professional consultation services to support their health, goals, and overall well-being.
• Public Service Loan Forgiveness Program employer.

Position Summary

As the PICS Unit Supervisor, you will supervise audit staff and review program integrity and compliance activities. You will also be responsible for reviewing and evaluating complex program compliance and financial audit reports; applying principles of management in the supervision of personnel; and be the project manager of two provider-type focused teams and as a result will matrix-manage Data and Research Analysts from the Business Intelligence Section (BIS).

Additionally, You Will

• guide the development and implementation of the provider-type focused teams’ data analysis, charters, work plans, all associated deliverables, and all subsequent work product.
• be responsible for directing team members’ work and ensuring timely completion of tasks on the teams’ work plans.
• ensure the quality of all work products through a pre-review of all routed documents and audit reports for compliance with federal and state Medicaid rules, regulations, and policies.
• evaluate the return on investment on teams’ projects and determine whether to continue, modify, or discontinue planned projects.

Other responsibilities include the provision of technical assistance to direct reports and matrix-managed staff, internal and external partners, and Medicaid providers. This position also evaluates complaints and makes recommendations on actions to take, and will also work with team members to identify, investigate, report, and mitigate allegations of fraud, waste, and abuse.

Salary Information

The starting pay is between $40.50 and $44.66 per hour (approximately between $84,200 and $92,900 per year), depending on qualifications, plus excellent benefits. A 12-month probationary period is required. Pay for current or former state employees will be set based on the rules that apply to compensation for the applicable transaction. This position is classified as a Financial Program Supervisor and is in pay schedule and range 81/03.

Job Details

• All applicants who may be appointed to this position will be required to allow DHS to conduct a background check to determine whether the circumstances of any conviction may be related to the job being filled.
• For positions that allow remote working flexibility, working outside of Wisconsin or in bordering cities will not be allowed except in extremely limited circumstances due to the need to report to an office location in Wisconsin on short notice.
• Employees must have access to secure high-speed internet for remote work option. Mileage reimbursement to the employee’s headquarter location is not provided. Remote work flexibility will be discussed in more detail during the interview process.
• DHS does not sponsor work visas for this position, thus, in compliance with federal law, selected candidates will be required to verify eligibility to work in the United States by completing the required I-9 form upon hire. DHS is not an E-Verify employer nor a STEM-OPT eligible employer.

Qualifications

• Experience conducting audits, quality reviews, record reviews, or compliance reviews.
• Experience developing or implementing new types of audits or quality/compliance reviews.
• Experience in a leadership or supervisory role (e.g., delegating and assigning work, mentoring and training, leading team projects or workgroups, etc.).

Well-qualified applicants

• Experience conducting Medicaid or other healthcare audits.
• Experience analyzing Medicaid or other healthcare data.
• Experience evaluating deliverables and providing feedback.
• Experience working with managed care or long-term care programs or pharmacies.

The letter of qualifications is limited to two (2) pages. For a guide on developing your resume and letter of qualifications and what should be included in these materials, click here.

DHS is an Equal Opportunity and affirmative action employer

DHS is an Equal Opportunity and affirmative action employer. Veterans are encouraged to apply. For complete information on veterans’ hiring programs with the WI Department of Veteran’s affairs, click here.

Deadline to Apply

The deadline to apply is September 8th, by 11:59 pm. Applicants are strongly encouraged to allow ample time to finalize their applications keeping in mind that technical assistance is only available Monday through Friday 7:45 am - 4:30 pm. Late or incomplete applications will not be accepted.