Office of the
Illinois Attorney General
Kwame Raoul

SUMMARY OF DUTIES AND RESPONSIBILITIES:

Under the direction of the Chief of Investigations in the Medicaid Fraud Control Unit, the Medicaid Fraud Supervisor is responsible for supervising and training the Intelligence Analysts, Data Analysts, and Forensic Financial Analysts. The Medicaid Fraud Supervisor will conduct analysis, audits, and examinations of alleged Medicaid provider fraud, including the development of audit and investigation objectives. They will oversee and participate in accessing, querying, and researching Medicaid claims data and related health care claims coding information; respond to investigator and examiner data requests; and interact and collaborate with investigators and examiners regarding data requests and data analysis.

The Medicaid Fraud Supervisor will oversee and assist analysts with the compiling, analysis, and audit of complex financial records and data to support investigation and prosecutions; support the development of liaison relationships with financial institutions and other agencies to facilitate records requests, production, and investigations; review and edit the documentation of investigative activities; assist in the evaluation of analysts performance; oversee and run queries; develop policies and procedures; prepare written reports and supporting exhibits such as charges and graphs to support analysis; and participate in strategic planning sessions with investigators, fraud investigative groups, and task forces.

MINIMUM QUALIFICATIONS:

This position requires a Bachelor’s or advanced degree in math, information technology, computer science, economics, accounting, finance, business, or related field, with responsible supervisory or management experience. Certification as a Certified Fraud Examiner (CFE) or Certified Public Accountant (CPA) is preferred. Candidates must demonstrate strong leadership, judgment, and problem-solving skills. Analytical, technological, communication, and organizational skills are required along with experience with Microsoft Office products. Additionally, working knowledge of i2 Analyst’s Notebook and Bank Scan is preferred. The ability to travel is required. Attendance, flexibility, outstanding written and communication skills, and the ability to build and maintain satisfactory working relationships with other agencies and OAG employees is required.

PREFERRED SKILLS:

Knowledge of the health care industry and medical coding concepts (CPT, ICD-9/10, DRGs, HCPCS) and/or experience analyzing health care claims data, experience with SAS Analytics Software and writing SQL data queries.

HOURS OF WORK:     9:00 a.m. - 5:00 p.m. (Monday - Friday)