Who We Are: Nebraska Department of Health and Human Services is a state agency that, "Helps People Live Better Lives" every day through our five different divisions; as one of those divisions, Medicaid and Long-Term Care (MLTC) encompasses the Medicaid program. Medicaid provides medical assistance to many Nebraskans statewide. We are seeking a Medicaid Provider Fraud and Abuse Investigator.Qualifications / Requirements
REQUIREMENTS: Post high school coursework/training in law enforcement, criminal justice, social/behavioral sciences or health related field, nursing, business or public administration, management, program analysis or evaluation of data systems. OR Experience in conducting fraud investigations, administrative investigations, utilization review, data systems, review of records and reports and evaluating their use and effectiveness, policy planning/analysis, casework, nursing, accounting or billing systems.
PREFER: Higher preference may be given to those with experience working with Medicaid claims, MMIS, and/or Medicaid provider regulations. The ideal candidate will also have experience in working on projects and/or implementing new initiatives and be a Certified Professional Coder (CPC) or a registered nurse.
OTHER: Valid driver's license or the ability to provide independent authorized transportation. Ability to travel as projects/initiatives dictate, and ability to work 8-5 core hours in addition to varied hours based on workload and project requirementsKnowledge, Skills and Abilities
Must have ability to travel as projects/initiatives dictate, and work 8-5 core hours in addition to varied hours based on workload and project requirements. Applicants must have excellent computer (word processing, database, spreadsheet, desk-top publishing, and on-line research) skills, and strong organizational and writing skills. Must be able to work efficiently and effectively as an individual and as part of a team. Attention to detail and accuracy, and a strong ability to handle multiple tasks concurrently are essential.
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