Auditor Senior - Office of the Inspector General

State of Wisconsin Madison, WI
This position acts as lead auditor in developing/conducting routine and complex specialized compliance, program, operational, procedural, investigative, and financial audits of health care entities who are reimbursed by the Title XIX Wisconsin Medicaid Program, (e.g. physicians/physician clinics, dentists, pharmacies, therapies (occupational, physical, speech), ambulances, federally qualified health centers, nursing homes, hospitals, etc), providing a variety of unique specialized medical care and services to Medicaid recipients. This position monitors contracts; develops audit programs for inclusion in the State Single Audit Guidelines of Counties; performs follow-up of any Medicaid non-compliance found by the Independent Auditor; and conducts internal program and economy and efficiency audits of the Medicaid Program to assure compliance with federal Medicaid State Agency regulations and procedures. Under the Affordable Care Act, conduct monthly on-site precertification reviews. The major goals are to assure the Department that medical care and services were rendered to Program beneficiaries and that incidents and practices did not cause a direct or indirect financial loss to the Medicaid Program or to beneficiaries and their families.

Special Notes: Due to the nature of the position, all applicants who may be appointed to this position may be required to allow the Department of Health Services to conduct a background check to determine whether the circumstances of any conviction may be related to the job being filled.

This position requires some travel to conduct onsite vendor activities. Occasional overnight stays may be required.

Qualifications:

Minimally qualified candidates will have:

Experience conducting and/or leading audits.

Experience interpreting policies, administrative rules, and/or regulations.

Experience presenting audit or project results in both written and verbal communications

Proficiency in Microsoft Office products.

In addition, well-qualified candidates will have:

Experience conducting audits in a healthcare setting.

Experience using data analysis tools such as iC or Business Objects to pull, analyze, and apply data to complete an audit or project.