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 Medicaid Regulatory & Fiscal Analyst

Be part of a dedicated team of professionals serving Vermonters. The Office of the Attorney General, Medicaid Fraud and Residential Abuse Unit (MFRAU) is seeking a full-time Medicaid Regulatory and Fiscal Analyst to join our  team of attorneys and investigators conducting data analysis for ongoing criminal and civil investigations. The MFRAU is part of the AGO’s Criminal Division and offers a unique and dynamic working environment.

MFRAU is responsible for investigating and prosecuting (a) fraud by healthcare providers in the Vermont Medicaid program; (b) fraud in the administration of the Vermont Medicaid program; (c) the abuse, neglect, and financial exploitation of individuals who live in Vermont skilled nursing facilities and board and care facilities; and (d) the abuse and neglect in “noninstitutional” settings where it involves a Medicaid recipient. MFRAU also brings affirmative civil claims on behalf of the State to enforce Vermont’s laws. Additionally, MFRAU works on cases arising under the Vermont False Claims Act involving Medicaid Fraud.

A Medicaid Regulatory and Fiscal Analyst will be expected to compile, analyze, and interpret data for both criminal and civil investigations, as well as produce written reports on their analysis. They also develop data queries to review, analyze, and  identify unusual utilization patterns that may indicate program fraud or abuse. Examples of analyzed data include medical billing codes, timesheets/payroll, medical service claims, and financial records.

Duties are performed with a high degree of independence, but investigations will be pursued as part of a team or in conjunction with other agencies. The individual selected for this position may also represent MFRAU at meetings and in committees with state and federal partners. Work is performed under the supervision of the Director of MFRAU. A successful candidate must be proficient with the Microsoft Office Suite of applications, including Word, Excel and SharePoint, as well as have experience working in complex databases. Experience in healthcare field and/or auditing/accounting is preferred.

The position is located at the Attorney General’s Office at 109 State Street in Montpelier, Vermont but some remote work is permitted. A career with the Vermont Attorney General’s Office provides the opportunity to do meaningful work in a positive and collegial environment. The State of Vermont offers a benefit package rivaling any employer in Vermont, which includes, but is not limited to: top-notch health care plan, generous sick and annual leave, employer contribution to retirement plans. The AGO recognizes the importance of a healthy work-life balance and supports the use of flexible workplace arrangements in accordance with AGO policies.

Hourly rates within the Classified Bargaining Unit Pay Plan will change effective July 3, 2022.  At that time, the step 1 starting rate for this job will be $26.42 per hour.