Olympia, Washington

Posted Date

September 5, 2023

Contact Information

Judith Vandergeest
judith.vandergeest@atg.wa.gov

WASHINGTON STATE OFFICE OF THE ATTORNEY GENERAL

Join an agency whose work impacts the lives of every resident of Washington State.
 
The Attorney General’s Office (AGO) touches the lives of every resident in this state.  We serve more than 230 state agencies, boards, commissions, colleges and universities, as well as the Legislature and the Governor.  The Office is comprised of nearly 700 attorneys and 800 professional staff, all working together to deliver the highest quality professional legal services to Washington state officials, agencies, and entities.  This includes:
 

  • Economic justice and consumer protections (safeguarding consumers, protecting youth, seniors, and other vulnerable populations)
  • Social justice and civil rights (addressing discrimination, environmental protection, and veteran and military resources)
  • Criminal justice and public safety (investigative and prosecutorial support, financial crimes)
  • And much more!

Our agency also has national reach, representing the State of Washington before the Supreme Court, the Court of Appeals and trial courts in all cases that involve the state’s interest.  If you want to make a difference, we may be the perfect fit for you!   Learn more about the AGO here.  

Commitment to Diversity
 
Diversity is critical to the success of the mission of the AGO. This means recognizing, respecting, and appreciating all cultures and backgrounds– and fostering the inclusion of differences between people.  Appreciating, valuing and implementing principles of diversity permits AGO employees to achieve their fullest potential in an inclusive, respectful environment.

One recent measure of the AGO’s commitment to diversity can be found in its nomination for Rainbow Alliance and Inclusion Network’s “Outstanding Agency Award” in 2019.  Our commitment to employee wellness is reflected in earning the 2022 “Zo8 Washington Wellness Award”.Division Information:

The work of the Office’s Medicaid Fraud Control Division (MFCD) focuses on both criminal and civil law enforcement. The 75% federally funded MFCD‘s mission is combating provider fraud, abuse and neglect in residential facilities and involving Medicaid recipients in non-institutional settings.

MFCD’s Headquarters is located in Olympia, Washington with some team members also located at the AGO’s Spokane Office and Seattle Office.  The Division currently has a staff of 60 FTEs, including attorneys, auditors, special agents, data analysts, clinical health investigators and professional support staff.

MFCD involves protecting not only the Medicaid program of roughly 13 billion dollars per annum, but also its most vulnerable persons, typically elderly persons in residential facilities or persons abused or neglected by a Medicaid Provider.  In many of our cases, there is no precedent so MFCD is consistently on the cutting edge of legal theories and issues.    The cases range from abuse and neglect of persons in nursing homes, large scale organized individual and corporate civil and criminal fraudulent activity to national whistleblower actions.    Our staff is a highly professional, fun and seasoned analytical investigative team.  MFCD is unique in that all cases have an attorney, special agent, data analyst assigned with legal support.  This, and the great people who make up the division, gives MFC a particularly terrific team atmosphere.

Responsibilities

Position and Salary Information
The Attorney General’s Office is recruiting for a permanent full time Financial Examiner 4 in the Medicaid Fraud Control Division. This position is located in Olympia, Washington, and Is represented by the Washington Federation of State Employees (WFSE).

Financial Examiner 4 Salary Range 70: $84,192 – $113,160
The base pay offered will take into account internal equity and may vary depending on the preferred candidate’s job-related knowledge, skills, and experience.

The following stipends may apply based on position requirements:

  • Incumbents assigned to our Seattle office location receive an additional 5% King County Location Pay stipend.
  • Incumbents assigned to a position designated as requiring dual language skills will receive a 5% Dual Language Requirement Pay stipend.

What does a Financial Examiner 4 do?

SUPERVISION:
This position has supervisory responsibility for three (3) direct reports with the classification of Financial Examiner 3 and will:

  • Ensure direct reports are maintaining case work information in accordance with the MFCD Operations Manual, including, but not limited to, Law Manager entries and maintaining information in the appropriate Outlook, F:drive folders, FAS folders, and FAS workload tracking spreadsheet.
  • Provide meaningful, viable and timely guidance to direct reports regarding their assigned activities and ensure assigned work is completed in a timely manner; conduct personnel evaluations and other required personnel paperwork, as well as approve leave requests for direct reports; prepare reports and associated documents concerning the performance of audits, data analytics and financial examinations and ensure that direct reports are accurately documenting their time in timekeeping; manage requests from the various sections in the Division and prioritize tasks for direct reports.

REVIEW/EVALUATE DIRECT REPORT: 
Planning and creating methodologies to identify and examine aberrant health care provider billing and financial misconduct, utilizing statistical valid sampling to conduct audits, examining and conducting analysis of complex financial transactions from financial institutions, performing forensic accounting review, utilize financial investigative software to examine and analyze financial documents/electronic banking, retrieving data sets from systems of regulated entities to investigate complex civil and criminal financial fraud in the most complex regulated industries of Medicaid and Qui Tam whistleblower actions in fee-for-service (FFS) and in managed care entities – who are funded through a capitated payment system and whose funding and rates are determined by historical expenditures and actuarial standards.

Developing complex data queries by using multiple software programs to access multiple data sets, analyzing billing and other data, mining data to identify potential fraudulent billing, and conducting financial and/or health care audits and civil/criminal investigations of pharmaceutical and other manufacturers of medical products, pharmacies, hospitals, skilled nursing facilities and other licensed and unlicensed facilities housing or caring for Medicaid recipients or receiving Medicaid funding, in support of MFCD investigations or inquiries and identifies fraudulent activity within audited facilities and provider practices.

Retrieving, evaluating, and analyzing all sources of data including paper documents, electronic, encounter, billing, actuarial, statistical data, rate setting, financial reports and other forms of data pertaining to the Medicaid program, including Managed Care and nursing facility entities; preparing audit, analytical, investigative, administrative reports, spreadsheets or associated documents; advising management concerning audit processes results and identifying areas of Medicaid program and process enhancement.

Logging, compiling, and extracting data to create documents and reports required to complete financial analysis/examinations; reading, analyzing, and examining filings, documents, and other information to assess the most complex regulated entity’s compliance with laws, regulations, and standards; prepares and completes checklists and/or additional analysis/examination of procedures/programs; evaluating analysis/examination procedures, programs, and finding. Writing analysis/examination reports for assigned cases.

Preparing reports, spreadsheets and other documents related to data analysis and investigative activities; assisting other federal and state audit and law enforcement agencies.
This is an expert level position representing the Washington State Attorney General’s Office in their interactions with regulated entity and healthcare provider fraud schemes and patterns of misconduct in the Medicaid program and long term care services for vulnerable adults including residential care facilities and personal care services. Fraud, and abuse and neglect cases are investigated through analyzing various types of financial records, healthcare records, and examination and evaluation of the adequacy of an institution’s or healthcare provider’s asset/liability management processes.

This position requires the individual to:
Stay apprised of complex regulations – both state and federal, to include but not limited to: Medicaid and Medicare program coverage, payment and compliance rules and regulations, applicable state agency rules and regulations to include licensing and certification of healthcare providers, federal and state false claim acts, anti-kickback and rebate regulations, Stark law, money laundering, and financial and banking institution regulations. Therefore, the individual must read and review updated applicable laws, regulations, and standards using both text and computer-based sources to ensure analyses and examinations are appropriately conducted; and interpret and apply applicable laws, rules, and standards.

Analyze financial statements includes income statements, balance sheets, cash flow and checks to assist with identifying fraud through the accuracy and completeness of current accounting standards. Conduct revenue and expenses records review to identify improper transactions. Assess accounts receivable and payable to confirm the accuracy of balances, invoices and analyze payment terms and aging records. Review financial records and medical data to ensure compliance with applicable laws, regulations and industry standards.
Reconstruct and analyzes various types of financial records, evaluates the adequacy of an institution’s asset/liability management processes by analyzing the institution’s exposure to changing interest rate environments; reviews fraud activities in Medicaid, financial institutions or financial service providers or issuers; analyzes/examines most complex regulated entities and determines compliance with applicable laws, regulations, and standards including, but not limited to, Medicaid and residential facility compliance, financial compliance, investment compliance, audit failure, antitrust, security sale compliance, or “Ponzi” schemes on a state, national, and international level.

This recruitment announcement may be used to fill multiple open positions for the same classification, in addition to the position(s) listed in this announcement.

 

Qualifications

What does a Financial Examiner 4 do?

SUPERVISION:
This position has supervisory responsibility for three (3) direct reports with the classification of Financial Examiner 3 and will:

  • Ensure direct reports are maintaining case work information in accordance with the MFCD Operations Manual, including, but not limited to, Law Manager entries and maintaining information in the appropriate Outlook, F:drive folders, FAS folders, and FAS workload tracking spreadsheet.
  • Provide meaningful, viable and timely guidance to direct reports regarding their assigned activities and ensure assigned work is completed in a timely manner; conduct personnel evaluations and other required personnel paperwork, as well as approve leave requests for direct reports; prepare reports and associated documents concerning the performance of audits, data analytics and financial examinations and ensure that direct reports are accurately documenting their time in timekeeping; manage requests from the various sections in the Division and prioritize tasks for direct reports.

REVIEW/EVALUATE DIRECT REPORT: 
Planning and creating methodologies to identify and examine aberrant health care provider billing and financial misconduct, utilizing statistical valid sampling to conduct audits, examining and conducting analysis of complex financial transactions from financial institutions, performing forensic accounting review, utilize financial investigative software to examine and analyze financial documents/electronic banking, retrieving data sets from systems of regulated entities to investigate complex civil and criminal financial fraud in the most complex regulated industries of Medicaid and Qui Tam whistleblower actions in fee-for-service (FFS) and in managed care entities – who are funded through a capitated payment system and whose funding and rates are determined by historical expenditures and actuarial standards.

Developing complex data queries by using multiple software programs to access multiple data sets, analyzing billing and other data, mining data to identify potential fraudulent billing, and conducting financial and/or health care audits and civil/criminal investigations of pharmaceutical and other manufacturers of medical products, pharmacies, hospitals, skilled nursing facilities and other licensed and unlicensed facilities housing or caring for Medicaid recipients or receiving Medicaid funding, in support of MFCD investigations or inquiries and identifies fraudulent activity within audited facilities and provider practices.

Retrieving, evaluating, and analyzing all sources of data including paper documents, electronic, encounter, billing, actuarial, statistical data, rate setting, financial reports and other forms of data pertaining to the Medicaid program, including Managed Care and nursing facility entities; preparing audit, analytical, investigative, administrative reports, spreadsheets or associated documents; advising management concerning audit processes results and identifying areas of Medicaid program and process enhancement.

Logging, compiling, and extracting data to create documents and reports required to complete financial analysis/examinations; reading, analyzing, and examining filings, documents, and other information to assess the most complex regulated entity’s compliance with laws, regulations, and standards; prepares and completes checklists and/or additional analysis/examination of procedures/programs; evaluating analysis/examination procedures, programs, and finding. Writing analysis/examination reports for assigned cases.

Preparing reports, spreadsheets and other documents related to data analysis and investigative activities; assisting other federal and state audit and law enforcement agencies.
This is an expert level position representing the Washington State Attorney General’s Office in their interactions with regulated entity and healthcare provider fraud schemes and patterns of misconduct in the Medicaid program and long term care services for vulnerable adults including residential care facilities and personal care services. Fraud, and abuse and neglect cases are investigated through analyzing various types of financial records, healthcare records, and examination and evaluation of the adequacy of an institution’s or healthcare provider’s asset/liability management processes.

This position requires the individual to:
Stay apprised of complex regulations – both state and federal, to include but not limited to: Medicaid and Medicare program coverage, payment and compliance rules and regulations, applicable state agency rules and regulations to include licensing and certification of healthcare providers, federal and state false claim acts, anti-kickback and rebate regulations, Stark law, money laundering, and financial and banking institution regulations. Therefore, the individual must read and review updated applicable laws, regulations, and standards using both text and computer-based sources to ensure analyses and examinations are appropriately conducted; and interpret and apply applicable laws, rules, and standards.

Analyze financial statements includes income statements, balance sheets, cash flow and checks to assist with identifying fraud through the accuracy and completeness of current accounting standards. Conduct revenue and expenses records review to identify improper transactions. Assess accounts receivable and payable to confirm the accuracy of balances, invoices and analyze payment terms and aging records. Review financial records and medical data to ensure compliance with applicable laws, regulations and industry standards.
Reconstruct and analyzes various types of financial records, evaluates the adequacy of an institution’s asset/liability management processes by analyzing the institution’s exposure to changing interest rate environments; reviews fraud activities in Medicaid, financial institutions or financial service providers or issuers; analyzes/examines most complex regulated entities and determines compliance with applicable laws, regulations, and standards including, but not limited to, Medicaid and residential facility compliance, financial compliance, investment compliance, audit failure, antitrust, security sale compliance, or “Ponzi” schemes on a state, national, and international level.

This recruitment announcement may be used to fill multiple open positions for the same classification, in addition to the position(s) listed in this announcement.

Application Process

For the complete job listing and to apply, email Judith Vandergeest or (360) 586-7691.