Medical Assistance Consultant III

Website HFSOIG Office of Inspector General, Illinois Department of Healthcare and Family Services

The Department of Healthcare and Family Services, Office of Inspector General seeks to hire a Medical Assistance Consultant III to analyze data on Medicaid providers and recipients to detect and identify current and emerging trends; and to identify potential fraud, waste, or abuse patterns. The ideal candidate will research for potential fraud through data mining methods and data interpretation and collaboration with other medical professionals to recommend appropriate actions not limited to audit, criminal prosecution, or peer review actions. Additionally, the candidate will compose and submit written analysis and recommendations to management for further review, or committee action, whether audit, investigation, or related actions, or inclusion in the Recipient Restriction Program.