Washington State Fraud Program Coordinator in Olympia, Washington


Fraud Program Coordinator WMS Band 2 Olympia, WA

First screening of applications is scheduled for October 14th.

The Health Care Authority (HCA) is Washington's largest health care purchaser, responsible for providing comprehensive health coverage to more than 2 million residents through the Public Employees Benefits and Medicaid programs. The agency provides health purchasing leadership, benefitting both public and private sectors with a focus on moving the health delivery system away from volume toward higher value and better outcomes.

The Olympia office is located in downtown Olympia, within walking distance of shops, restaurants, bus lines, and less than one (1) mile from the freeway.

Position Objective: The Office of Audit & Accountability (A&A;) is an independent and objective assurance and consulting activity that is guided by a philosophy of improving the operations of the Health Care Authority. It helps HCA accomplish its objectives by bringing a systematic, disciplined approach to evaluate and improve the effectiveness of risk management, controls, and governance processes.

The Fraud Program Coordinator reports to the Audit & Accountability Manager, and is responsible for ensuring HCA's compliance with the activities established in 42 CFR 455.21 Cooperation with State Medicaid fraud control units, and in RCW 74.66, the Medicaid Fraud False Claims Act.

This position adheres to The Institute of Internal Auditors Code of Ethics and Rules of Conduct, which incorporate the following basic principles:

  • Integrity

  • Objectivity

  • Confidentiality

  • Competency

This position will perform the following work:

  • Develop and manage an agency-wide client/provider fraud program in Health Care Authority.
  • Research, develop, and maintain policies, program guides, practices, templates, and tools to assist HCA in complying with IIA Standards and staying up-to-date with emerging fraud detection and prevention practices.
  • Serve as the agency's expert on fraud investigations.
  • Develop and maintain an agency-wide data base of complaints.
  • Participate in the development of the Office of Audit & Accountability annual audit plan, having responsibility for preparing the portion of the plan that discusses fraud program activities.
  • Prepare formal and informal reports, memorandums, and or presentations regarding fraud investigations, the HCA fraud program, rules and regulations, and other training, reporting or networking opportunities as identified and/or requested. Qualifications Required Qualifications:

  • Bachelor's degree from an accredited school in

  • Accounting, business administration or a closely related field;
  • Public health or a related field; OR
  • Information technology, computer sciences or related field.
  • At least one year professional audit experience in federal, state, or local government , which includes:
  • Managing complex engagements or projects
  • Providing services that meet or exceed professional standards and reflects the commitment to ongoing improvement.
  • Project planning and objective setting
  • Developing audit programs
  • Using effective techniques for communicating and asking questions in ways that enhance clarity, information flow, and reliability of information.
  • Identifying, collecting, organizing, and analyzing information in ways that are useful for achieving accurate results, while giving appropriate attention to detail and accuracy.
  • Drawing conclusions and recommendations that are professionally sound and add value.
  • Meeting deadlines
  • Report writing and/or presentations
  • Employing expertise, credibility, and effective partnering to proactively identify agency needs and to help clients evaluate, and resolve complex or sensitive issues.
  • Current, advanced knowledge of IIA standards, the IIA Code of Ethics, and the auditing discipline, as evidenced by experience conducting training or making presentations and/or the ability to discuss these topics in an informed, logical manner.
  • Demonstrated organizational and political awareness, relationship building skills, and effective decision making skills. *Preferred/Desired Qualifications: *

  • Professional certification such as Certified Public Accountant, Certified Internal Auditor, Certified Fraud Examiner, Certified Government Audit Professional, etc.

  • Knowledge of federal laws and regulations dealing with Medicaid fraud
  • Knowledge of health insurance industry and/or state-managed health care services. *Please Note the Following: * Application assessment will be ongoing and the hiring authority reserves the right to offer the position at any time during the recruitment process. It is to the applicant's advantage to apply as early as possible.

*How to Apply: * Failure to follow the application instructions below may lead to disqualification. To apply for this position you will need to complete your profile within http://careers.wa.gov and attach to your profile before completion:

  • A cover letter
  • Current resume
  • Three professional references Only candidates who reflect the minimum qualifications on their State application will be considered.

If you have questions about the process, or need assistance, please contact the recruiter listed below before the posting closes. The candidate pool certified for this recruitment may be used to fill future similar vacancies for up to the next six months.

Contact us: * For inquiries about this position, please contact *Sanyu Tushabeat 360-725-1180 or email to Sanyu.Tushabe@hca.wa.gov.

**Persons under final consideration for initial appointment with HCA are subject to a background check.

Washington State is an equal opportunity employer. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may call the Human Resources Office at 360.725.1180 or emailSanyu.Tushabe@hca.wa.gov.

Job Type: Full Time - Permanent

Job Number: 2016-10152

Department: Health Care Authority

Closing: Continuous

Agency: State of Washington

Address: View Job Posting for Agency Information View Job Posting for Location, Washington, 98504.

Website: http://www.careers.wa.gov

Salary: $60,672.00 - $84,936.00 Annually

Location: Thurston County – Olympia, WA