This position is located in the Department of Health and Human Services, Office of Inspector General, Office of Evaluation and Inspections. The announcement will close at 11:59p.m. EST on the date the applicant limit has been reached which may be sooner than the closing date. Resumes must be no more than 2-pages in length.
Duties for the Medicaid Fraud Oversight Specialist, GS-0301-12 include but not limited to: Recommends comprehensive solutions to MFCU Oversight Division (MOD) director and other OIG officials that will further the purpose and objective of the MFCU grant program.
Analyzes and evaluates recertification applications and other materials to ensure that MFCUs are adhering to published performance standards as well as applicable law and regulations Analyzes sources of information in support of inspections, from evidence, including databases, to establish the accuracy and authenticity of the information.
Works to improve effectiveness of the MFCUs by assisting with oversight issues; identifying available resources, such as subjectexperts and data systems; and encouraging collaboration with OIG on fraud cases and other initiatives.
Works on MFCU-related special assignments comprised of sensitive and/or confidential information about specific issues pertaining to Medicaid provider fraud and patient abuse or neglect and executes all aspects of the MFCU oversight process in an accurate and timely manner.
Conducts periodic onsite reviews of selected MFCUs, in compliance with evaluation standards of the Council for the Inspectors General on Integrity and Efficiency (CIGIE) and prepares written reports of those reviews. Proposes recommended courses ofaction based upon the review, such as corrective action or other grant sanctions. Makes oral presentations on findings andrecommendations.
In collaboration with statisticians, information technology, and other experts, collects and analyzes statistical and other pertinent data from various sources and assists with the preparation of the Annual MFCU report. Supports enhanced and targeted evaluation reviews for selected states conducted by regional off ices. Serves as the primary subject matter expert for those reviews and provides logistical and analytical support.
Coordinates oversight activities as necessary with the Centers for Medicare & Medicaid Services (CMS), Administration for Community Living (ACL), and other HHS and Federal agencies. Prepares responses to Congressional and other types of correspondence and requests for information regarding MFCU matters.
Represents MOD at conferences, training sessions, and meetings to disseminate information, provide technical advice, and present training on the MFCU oversight to various-sized audiences.
catherine.gabrielle@oig.hhs.gov
This position is with Office of Inspector General, Department of Health and Human Services.
The posted pay range is $111896 – $145468/yr.
This position is eligible for telework.
Applications close on 2026-09-21.
This position is open under the 'Fed Transition' hiring path.
Source: USAJOBS.gov — U.S. Federal Government
Apply on official site →