Auditor

Overview

Interested in fighting healthcare fraud using your analytical and quantitative skills? Seeking to help recover stolen funds, protect the Medi-Cal Program against false claims submitted for payment to the State of California and help protect the vulnerable population? The Division of Medi-Cal Fraud and Elder Abuse is looking for talented auditors with superlative data management and investigative skills and a commitment to detecting and combating fraud – this is an opportunity highly qualified applicants should not miss.

Interested in fighting healthcare fraud using your analytical and quantitative skills? Seeking to help recover stolen funds, protect the Medi-Cal Program against false claims submitted for payment to the State of California and help protect the vulnerable population? The Division of Medi-Cal Fraud and Elder Abuse is looking for talented auditors with superlative data management and investigative skills and a commitment to detecting and combating fraud – this is an opportunity highly qualified applicants should not miss.

• Conducts complex civil audits and investigations for the Civil Section, including:
  • Work with auditors and attorneys from other state Medicaid Fraud Control Units and/or Federal Assistant United States Attorneys to combat global health fraud. Review and provide claims data of suspected activity and assist in civil remediation.
  • Obtains and analyzes information from Medi-Cal claims database(s) and other evidence obtained from a variety of sources associated with cases and complaints of alleged Medi-Cal provider fraud.
  • Identifies, gathers, and maintains voluminous data relevant to such allegations.
  • Estimating and calculating monetary losses to the Medi-Cal program, including determining the reasonableness of audit findings and evaluating such results through comparative analysis and independent third-party verification.
  • Conducting interviews, performing any and all fieldwork needed for the audit or investigation, compiling and evaluating competent evidentiary material, developing audit findings, preparing detailed reports of investigation and schedules of findings that result from investigative activities and records examinations.
  • Participating in meetings, depositions, and interviews with qui tam relators, investigative, legal, and managerial staff, as well as private law firms and various governmental agencies.
  • Developing forensic investigative strategies and identifying resources necessary to perform various audit and investigative assignments.
  • Collaborating with teams of attorneys, paralegals, support staff, investigators, agents and auditors, and other analysts both within and beyond the Division.
  • Utilizing computerized audit techniques with tools including MIS/DSS claims database, Business Objects, Medi-Cal Management Information System, Lexis-Nexis, Microsoft Office Suite, SAS Enterprise Guide to develop programs and other information for sampling, cost evaluations, determining patterns, and trend analysis.
  • Assisting in the preparation (including drafting) and service of subpoenas, as well as in the preparation of discovery requests and discovery responses.
  • Assisting in the preparation of matters set for hearing, settlement, and trial, including testifying in civil hearings, depositions, and trials both in person and by affidavit.

You will find additional information about the job in the Duty Statement
.

• Job Code #: JC-504230
• Position #(s): -003
• Working Title
  :
  Auditor I
• Classification
  : AUDITOR I
• Salary
  : $4,256.00 - $5,600.00
• Salary Note
  :
  New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable.
• Shall Consider
  : INVESTIGATIVE AUDITOR III, Department of Justice
• Salary Range
  : $6,646.00 - $8,740.00
• Shall Consider (cont.): INVESTIGATIVE AUDITOR II, Department of Justice
• Salary Range
  : $5,528.00 - $7,269.00
• Shall Consider (cont.): INVESTIGATIVE AUDITOR IV (SPECIALIST), Department of Justice
• Salary Range
  : $6,955.00 - $9,142.00
• Number of Positions
  : 1
• Work Location
  :
  Sacramento County
• Telework
  :
  Hybrid
• Job Type
  :
  Permanent, Full Time
• Work Shift
  :
  Day
• Work Week
  :
  Monday - Friday

• This position is located in the Division of Medi-Cal Fraud and Elder Abuse, Civil Section, San Diego Regional Office or Sacramento Regional Office. There is a total of 1 position. This position may be filled in either San Diego (JC-504219) or Sacramento (JC-504230). Applications are welcome for both locations and only one (1) STD 678 State Application is needed. Please clearly indicate your preferred city or cities and the corresponding JC code(s) in the “Examination or Job Title(s) For Which You Are Applying” section of your State Application.
• Please disregard the SROA/Surplus language below, as the Department of Justice requires applicants to submit their SROA/Surplus Letter if that is the basis of their eligibility.
• Please note that all new to-state employees will be given the minimum salary of the…