... Management Consultant II. 35% Create customized downloads from on-line Medicaid claims data ... E-verify is a program that electronically confirms an employee's eligibility to work in the United ...
... Management Consultant II. 35% Create customized downloads from on-line Medicaid claims data ... E-verify is a program that electronically confirms an employee's eligibility to work in the United ...
MEDICAID FRAUD ANALYST II - 41001293 1
Orlando, FL · On-site
$57K/yr
... Management Consultant II. 35% Create customized downloads from on-line Medicaid claims data ... E-verify is a program that electronically confirms an employee's eligibility to work in the United ...
MEDICAID FRAUD ANALYST II - 41001293 1
Orlando, FL · On-site
$57K/yr
... Management Consultant II. 35% Create customized downloads from on-line Medicaid claims data ... E-verify is a program that electronically confirms an employee's eligibility to work in the United ...
... Management Consultant II. 35% Create customized downloads from on-line Medicaid claims data ... E-verify is a program that electronically confirms an employee's eligibility to work in the United ...
... Management Consultant II. 35% Create customized downloads from on-line Medicaid claims data ... E-verify is a program that electronically confirms an employee's eligibility to work in the United ...
68048426 - MEDICAL/HEALTH CARE PROGRAM ANALYST
Jacksonville, FL · On-site
$1.8K - $2.3K/wk
The Medicaid program provides low-income families and individuals with access to health care. If ... Coordinates with Medicaid recipients, providers, policy staff, plan management staff, and SMMC ...
68048426 - MEDICAL/HEALTH CARE PROGRAM ANALYST
Jacksonville, FL · On-site
$1.8K - $2.3K/wk
The Medicaid program provides low-income families and individuals with access to health care. If ... Coordinates with Medicaid recipients, providers, policy staff, plan management staff, and SMMC ...
68022240 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST
Doral, FL · On-site
$1.6K - $2.1K/wk
Medicaid Managed Care Waivers; and Medicaid program manuals. Remains informed about Choice Counseling procedures, including the For Cause process. Remains informed about the operations of the ...
68022240 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST
Doral, FL · On-site
$1.6K - $2.1K/wk
Medicaid Managed Care Waivers; and Medicaid program manuals. Remains informed about Choice Counseling procedures, including the For Cause process. Remains informed about the operations of the ...
68900289 - OPS MEDICAL/HEALTH CARE PROGRAM ANALYST
Miami, FL · On-site
$20/hr
The Bureau of Medicaid Program Integrity (MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or ...
68900289 - OPS MEDICAL/HEALTH CARE PROGRAM ANALYST
Miami, FL · On-site
$20/hr
The Bureau of Medicaid Program Integrity (MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or ...
68900227 - OPS SR HUMAN SERVICE PROGRAM SPEC
Tallahassee, FL · On-site
$17.53 - $18/hr
... Medicaid providers. Staff prepare and issue sanction notices, and manage cases through the sanction ... program support functions. LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS N/A CONTACT:
68900227 - OPS SR HUMAN SERVICE PROGRAM SPEC
Tallahassee, FL · On-site
$17.53 - $18/hr
... Medicaid providers. Staff prepare and issue sanction notices, and manage cases through the sanction ... program support functions. LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS N/A CONTACT:
68900227 - OPS SR HUMAN SERVICE PROGRAM SPEC
$17.53 - $18/hr
... Medicaid providers. Staff prepare and issue sanction notices, and manage cases through the sanction ... program support functions. LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS N/A CONTACT:
68900227 - OPS SR HUMAN SERVICE PROGRAM SPEC
$17.53 - $18/hr
... Medicaid providers. Staff prepare and issue sanction notices, and manage cases through the sanction ... program support functions. LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS N/A CONTACT:
68900227 - OPS SR HUMAN SERVICE PROGRAM SPEC
Tallahassee, FL · On-site
$17.53 - $18/hr
... Medicaid providers. Staff prepare and issue sanction notices, and manage cases through the sanction ... program support functions. LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS N/A CONTACT:
68900227 - OPS SR HUMAN SERVICE PROGRAM SPEC
Tallahassee, FL · On-site
$17.53 - $18/hr
... Medicaid providers. Staff prepare and issue sanction notices, and manage cases through the sanction ... program support functions. LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS N/A CONTACT:
68065041 - GOVERNMENT OPERATIONS CONS III
Tallahassee, FL · On-site
$1.9K - $2.5K/wk
... program policies, including: all Medicaid federal authorities (e.g. the Florida State Plan, 1115 waivers and home and community-based waivers), administrative rules, coverage policies, managed care ...
68065041 - GOVERNMENT OPERATIONS CONS III
Tallahassee, FL · On-site
$1.9K - $2.5K/wk
... program policies, including: all Medicaid federal authorities (e.g. the Florida State Plan, 1115 waivers and home and community-based waivers), administrative rules, coverage policies, managed care ...
68065041 - GOVERNMENT OPERATIONS CONS III
$1.9K - $2.5K/wk
... program policies, including: all Medicaid federal authorities (e.g. the Florida State Plan, 1115 waivers and home and community-based waivers), administrative rules, coverage policies, managed care ...
68065041 - GOVERNMENT OPERATIONS CONS III
$1.9K - $2.5K/wk
... program policies, including: all Medicaid federal authorities (e.g. the Florida State Plan, 1115 waivers and home and community-based waivers), administrative rules, coverage policies, managed care ...
... Medicaid Managed Care Waivers and Medicaid program manuals. The incumbent in this position shall remain informed about the operations of the Medicaid fiscal agent; including Medicaid claims ...
... Medicaid Managed Care Waivers and Medicaid program manuals. The incumbent in this position shall remain informed about the operations of the Medicaid fiscal agent; including Medicaid claims ...
... Medicaid Managed Care Waivers and Medicaid program manuals. The incumbent in this position shall remain informed about the operations of the Medicaid fiscal agent; including Medicaid claims ...
... Medicaid Managed Care Waivers and Medicaid program manuals. The incumbent in this position shall remain informed about the operations of the Medicaid fiscal agent; including Medicaid claims ...
68020522 - AGENCY FOR HEALTH CARE ADMINISTRATOR - SES
Tallahassee, FL · On-site
$2.0K - $3.8K/wk
... Medicaid Managed Care Waivers and Medicaid program manuals. The incumbent in this position shall remain informed about the operations of the Medicaid fiscal agent; including Medicaid claims ...
68020522 - AGENCY FOR HEALTH CARE ADMINISTRATOR - SES
Tallahassee, FL · On-site
$2.0K - $3.8K/wk
... Medicaid Managed Care Waivers and Medicaid program manuals. The incumbent in this position shall remain informed about the operations of the Medicaid fiscal agent; including Medicaid claims ...
68064269 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST
Jacksonville, FL · On-site
$1.6K - $2.1K/wk
The Medicaid program provides low-income families and individuals with access to health care. If ... Coordinates with Medicaid recipients, providers, policy staff, plan management staff, and Statewide ...
68064269 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST
Jacksonville, FL · On-site
$1.6K - $2.1K/wk
The Medicaid program provides low-income families and individuals with access to health care. If ... Coordinates with Medicaid recipients, providers, policy staff, plan management staff, and Statewide ...
The Medicaid program provides low-income families and individuals with access to health care. If ... Coordinates with Medicaid recipients, providers, policy staff, plan management staff, and Statewide ...
The Medicaid program provides low-income families and individuals with access to health care. If ... Coordinates with Medicaid recipients, providers, policy staff, plan management staff, and Statewide ...
The Medicaid program provides low-income families and individuals with access to health care. If ... Coordinates with Medicaid recipients, providers, policy staff, plan management staff, and Statewide ...
The Medicaid program provides low-income families and individuals with access to health care. If ... Coordinates with Medicaid recipients, providers, policy staff, plan management staff, and Statewide ...
68025505 - ADMINISTRATIVE SECRETARY
Tallahassee, FL · On-site
$1.3K - $1.7K/wk
This position is located in the Bureau of Medicaid Program Finance (MPF). MPF manages and projects Florida's $34.4 billion Medicaid Services budget, oversees financial reporting of the Agency ...
68025505 - ADMINISTRATIVE SECRETARY
Tallahassee, FL · On-site
$1.3K - $1.7K/wk
This position is located in the Bureau of Medicaid Program Finance (MPF). MPF manages and projects Florida's $34.4 billion Medicaid Services budget, oversees financial reporting of the Agency ...
Medicaid Benefits Counselor
Saint Petersburg, FL · On-site
$21.50/hr
Counsel individuals on the Statewide Medicaid Managed Care Long-term Care Program (SMMCLTCP), available services, eligibility requirements, the application process, and additional information sources.
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Medicaid Benefits Counselor
Saint Petersburg, FL · On-site
$21.50/hr
Counsel individuals on the Statewide Medicaid Managed Care Long-term Care Program (SMMCLTCP), available services, eligibility requirements, the application process, and additional information sources.
68064215 - REGISTERED NURSING CONSULTANT
Tallahassee, FL · On-site
$2.8K/wk
Medicaid Quality provides data-driven, focused and systematic feedback on the quality of Florida's Medicaid program to federal and state agencies, Medicaid recipients, Medicaid managed care plans ...
68064215 - REGISTERED NURSING CONSULTANT
Tallahassee, FL · On-site
$2.8K/wk
Medicaid Quality provides data-driven, focused and systematic feedback on the quality of Florida's Medicaid program to federal and state agencies, Medicaid recipients, Medicaid managed care plans ...
Medicaid Program Manager information
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$57K/yr
Other
Medical, Dental, Vision, Life, Retirement
Posted 15 days ago
State Of Florida rating
6.6
Based on 186 frontline employees who took The Breakroom Quiz
46th of 50 rated states
Job description
Requisition No: 879395
Agency: Office of the Attorney General
Working Title: MEDICAID FRAUD ANALYST II - 41001293 1
Pay Plan: Career Service
Position Number: 41001293
Salary: $57,783.18 annually
Posting Closing Date: 08/04/2026
Total Compensation Estimator Tool
Our Organization and Mission: The Office represents the State of Florida in state and federal civil and criminal courts, from trial courts to the Supreme Court of the United States.
Position Summary: This Medicaid Fraud Analyst II position is in the Office of the Attorney General within Medicaid Fraud Control Unit in Orlando and Tallahassee, Florida. If the selected candidate choose the Tallahassee location, candidate will requested for the position to be moved from Orlando to Tallahassee at that time.
Pay: $57,783.18 Annually
Qualifications:
Five (5) years of experience in research, investigations, investigative analysis or statistics; or
A Bachelor degree from an accredited college or university and one (1) year of professional experience in research, investigations, investigative analysis or statistics.
Preference will be given to candidates who have experience compiling and analyzing investigative information, or experience in the use of spreadsheets and relational database applications.
**SKILLS VERIFICATION TEST ** All applicants who meet the screening criteria/minimum job requirements will be required to take a timed Skills Verification Test. Applicants must receive a score of at least 70% to move to the interview phase.
The Work You Will Do: The responsibilities of this position include, but are not limited to the following:
An employee in this position provides analytical support for attorneys and investigators in Florida-specific and multistate health care fraud investigations and litigation matters. An employee in this position also performs work conducting detailed research and analysis of investigative information relating to alleged violations of applicable laws pertaining to health care fraud, in the administration of the Medicaid program, and/or the alleged abuse or neglect of patients in health care facilities governed by the State Medicaid program. An employee in this position may also perform as lead analyst on specialized complex civil enforcement investigations and litigation matters and analytical projects.
Additional roles and duties to design and write new EDW ad hoc reports and queries, serve as a MFCU analyst providing EDW support throughout the MFCU, and serve as an instructor on the new EDW to the various MFCU regional offices, in support of Operations & Management Consultant I and Operations & Management Consultant II.
35% Create customized downloads from on-line Medicaid claims data warehouse as requested by investigators, attorneys, and multistate investigative and litigation teams.
25% Prepare reports/schedules/charts pertaining to all aspects of the analysis and research for use in criminal prosecution, civil actions and administrative referrals.
20% Assists and supports Medicaid fraud investigators and attorneys in the compilation and analysis of investigative information and the development of damages models for use in Florida-specific and multistate health care fraud investigations and litigation. Obtains and analyzes large amounts of data to: interpret and summarize health care fraud activity, calculate damages sustained to the Florida Medicaid program, determine significance, completeness and usefulness of data, recognize and identify patterns and trends, and brief investigators and attorneys.
10% Extract information from investigative databases. Compile, analyze and disseminate intelligence information retrieved from various computer databases/systems. Perform various duties related to computers.
5% Assist in the prosecution of Medicaid fraud and/or patient abuse to include testimony in courts of law pertaining to the investigation.
5% Other duties as assigned.
Candidate Profile (application) must be completed in its entirety.
- Include supervisor names and phone numbers for all periods of employment.
- Account for and explain any gaps in employment so that the hiring process is not delayed.
- Experience, education, training, knowledge, skills and/or abilities as well as responses to pre-qualifying questions must be verifiable to meet the minimum qualifications.
- It is unacceptable to use the statement "See Resume" in place of entering work history.
- If you experience problems applying online, please call the People First Service Center at (877) 562-7287.
The Benefits of Working for the State of Florida: Working for the State of Florida is more than a paycheck. The State's total compensation package for employees features a highly competitive set of employee benefits including:
- Annual and Sick Leave benefits.
- Nine paid holidays and one Personal Holiday each year.
- State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options.
- Retirement plan options, including employer contributions (For more information, please click www.myfrs.com).
- Flexible Spending Accounts
- Tuition waivers.
- And more! For a more complete list of benefits, visit www.mybenefits.myflorida.com.
IMPORTANT NOTICE: To be considered for the position, all applicants must:
Submit a complete and accurate application profile necessary for qualifying such as dates of service, reason for leaving, etc. In addition, all applicants must ensure all employment and/or detailed information about work experience is listed on the application (including military service, self-employment, job-related volunteer work, internships, etc.) and that gaps in employment are explained.
NOTE: Any required experience and/or preferences listed in the advertisement must be verified at the time of application.
- Ensure that applicant responses to qualifying questions are verifiable by skills and/or experience stated on the employment application and/or resume. Applicants who do not respond to the qualifying questions will not be considered for this position.
- The elements of the selection process may include a skill assessment exercise.
- Current and future vacancies may be filled from this advertisement for a period of up to six months. Following the six-month period, a new application must be submitted to an open advertisement to be considered for that vacancy.
- OAG employees are paid biweekly. All state employees are required to participate in the direct deposit program pursuant to s. 110.113, F.S.
CRIMINAL BACKGROUND CHECKS/ DRUG FREE WORKPLACE: All OAG positions are "sensitive or special trust" and require favorable results on a background investigation including fingerprinting, pursuant to s. 110.1127(2)(a), F.S. The State of Florida supports a Drug-Free Workplace, all employees are subject to reasonable suspicion or other drug testing in accordance with section 112.0455, F.S., Drug-Free Workplace Act. We hire only U.S. citizens and those lawfully authorized to work in the U.S.
E-VERIFY STATEMENT: The Office of the Attorney General participates in the U.S. government's employment eligibility verification program (e-verify). E-verify is a program that electronically confirms an employee's eligibility to work in the United States after completion of the employment eligibility verification form (i-9).
PERSONS WITH DISABILITY/ADA STATEMENT: The OAG supports the employment of individuals with disabilities and encourages them to seek employment within our agency. If you need an accommodation because of a disability, as defined by the Americans with Disabilities Act, in order to participate in the application process, please notify the people first service center at 877-562-7287. If you need an accommodation during the selection process, please notify the hiring authority in advance to allow sufficient time to provide an accommodation.
REMINDERS: Male applicants born on or after October 1, 1962, will not be eligible for hire or promotion unless they are registered with the Selective Service System (SSS) before their 26th birthday, or have a Letter of Registration Exemption from SSS. For more information, please visit the SSS website at: https: //www.sss.gov. If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. If you return to FRS employment before satisfying the required waiting period, your retirement may be voided, and you may have to repay all benefits you have received, including any Deferred Retirement Option Program (DROP) payout.
The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.
Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.
The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.
VETERANS' PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans' Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans' Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans' Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.
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Industry
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Company size
10,000+ Employees
Headquarters location
Tallahassee, FL, US