Department of Health and Human Services

Supervisory Medicaid Fraud Specialist

Salt Lake City, Utah, Seattle, Washington, Phoenix, Arizona, Los Angeles, California, San Francisco, Full time

Supervisory Medicaid Fraud Specialist

Department: Department of Health and Human Services

Location(s): Salt Lake City, Utah, Seattle, Washington, Phoenix, Arizona, Los Angeles, California, San Francisco, California, Denver, Colorado, Washington, District of Columbia, Miami, Florida, Atlanta, Georgia, Chicago, Illinois, Indianapolis, Indiana, New Orleans, Louisiana, Boston, Massachusetts, Minneapolis, Minnesota, Kansas City, Missouri, Albuquerque, New Mexico, New York, New York, Oklahoma City, Oklahoma, Portland, Oregon, Austin, Texas

Salary Range: $146481 - $190424 Per Year

Job Summary: This position is located in the Department of Health and Human Services, Office of Inspector General, Office of Evaluation and Inspections, You must meet the requirements of the job by 11:59 (Eastern Standard Time) of the closing date: 12/24/2025. Resumes must be no more than 2-pages in length. There is one vacancy that may be located at any one of the following locations: Atlanta, GA; Boston, MA; Chicago, IL; Dallas, TX; Kansas City, KS; Philadelphia, PA; San Fransico, CA; Washington, DC.

Major Duties:

  • Oversee the Medicaid Fraud Control Unit Oversight Division (MOD), which has oversight of the 53 State Medicaid Fraud Control Units (MFCUs) and recertifies and conducts onsite reviews of the MFCUs to ensure compliance with the 12 MFCU Performance Standards established by OIG, in accordance with section 13625 of the Omnibus Budget Reconciliation Act of 1993. Provide direction and guidance for MFCU oversight functions, working with OIG components, State MFCUs, and others to carry out the mission of MOD. Supervise and monitor research on legal and program issues concerning the interpretation, application, and enforcement of MFCU-related statues, rules, and regulations. Advise and inform OIG and other officials on matters under the Division's purview. Supervise MOD staff responsible for a variety of planning, reporting, research, data collection, and analytic tasks. Develop and direct the work of MOD staff, including establishing priorities and overseeing schedules for completion of work.

Qualifications: Applicants must meet all the qualification requirements, including education, and any selective placement factors described below within 30 days of the closing date of this announcement. Applicants must have 1 year of specialized experience equivalent to the next lower grade level in the Federal service which provided the applicant with the knowledge, skills and abilities to perform the duties of the position. Qualifying specialized experience must demonstrate the following: Apply a wide range of qualitative and/or quantitative methods for the assessment and improvement of program effectiveness and improvement of complex processes related to Medicaid program integrity; Administer oversight of programs that are responsible for preventing, detecting, or taking enforcement action against Medicaid fraud; AND Contribute to the development of materials to advise and inform officials on matters of Medicaid program integrity effectiveness and improvement. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Your resume should include the dates of all qualifying experience (from month/year to month/year) and the number of hours worked/volunteered per week. Federal experience is not required. The experience may have been gained in the public sector, private sector or Volunteer Service. One year of experience refers to full-time work; part-timework is considered on a prorated basis. To ensure full credit for your work experience, please indicate dates of employment by month/year, and indicate number of hours worked per week, on your resume.

How to Apply: To begin the process, click the Apply Online button to create an account or log in to your existing USAJOBS account. Follow the prompts to complete the assessment questionnaire. Please ensure you click the Submit My Answers button at the end of the process. Resume must be limited to two-pages to receive consideration. A complete application package for this vacancy must be received on-line via the USA Staffing web site by 11:59 PM (EST) on 12/24/2025 to receive consideration. Mailed/emailed applications will not be accepted. Note: For information on how to edit your application, visit: USA Jobs Help: Updating your submitted application Questions regarding this vacancy or the application process should be directed to the HR Specialist. This announcement may be used to fill one or more vacancies.

Application Deadline: 2025-12-24