Medicaid Fraud And Compliance

Medicaid Fraud And Compliance Data Jobs

2 jobs found

Today

Data Analyst - 340B Compliance

The University of Mississippi Medical Center Jackson, MS

Jackson, MS

Today

Full time 340b Program Analytics Business Analytics

Apply Now

Job Description

Support the University of Mississippi Medical Center’s 340B Pharmacy compliance and audit readiness through ongoing program coordination and data-driven monitoring.

Responsibilities

Conduct 340B audits and help ensure facility adherence to 340B regulations and guidelines, including Medicaid
Monitor and audit claims to support compliance with 340B Program requirements
Ensure compliance for qualified patients, drugs, and locations in coordination with the 340B compliance coordinator
Support readiness for HRSA and manufacturing audits
Develop a thorough understanding of the split-billing system and relevant functions
Educate stakeholders involved in purchasing to promote proper operation and compliance
Coordinate purchasing for split inventory across internal and contract pharmacies
Review and ensure compliance across the 340B inventory purchasing process for applicable inpatient and outpatient pharmacies
Assess opportunities for cost savings and system improvements to support higher compliance
Work to consistently improve the overall efficiency, value, and internal support of the 340B Program
Build knowledge of the healthcare and pharmacy services industry and use it to recommend improvements to the 340B Program
Develop reports to educate staff and assist management with monitoring and tracking overall financial impact and performance
Maintain copies of reports for compliance and audit purposes
Identify root causes of adverse trends and recommend corrective improvements
Maintain policies and procedures for 340B purchasing processes to support ongoing compliance
Develop policies and processes with the 340B compliance coordinator to limit program liabilities, support audits, reduce risk, prevent duplicate discounts, and prevent diversion
Develop appropriate 340B quality assurance training for employees

Requirements

Bachelor’s degree in health management, finance, business, or related field
OR High School diploma plus Four years of pharmacy tech experience that is deemed sufficient for providing leadership and ownership of 340B analyst functions
OR 1 year of 340B analyst work experience
Pharmacy Technician Registration with the Mississippi State Board of Pharmacy if using work experience in lieu of education

Technologies

Excel
Split billing software

Physical and Environmental Demands

Occasional exposure to unpleasant or disagreeable physical environment such as high noise levels and exposure to heat and cold
Occasional working hours significantly beyond regularly scheduled hours
Frequent travel to offsite locations
Occasional activities subject to significant volume changes of a seasonal or clinical nature
Frequent work produced subject to precise measures of quantity and quality
Occasional bending
Occasional lifting and carrying up to 50 pounds

Location: Jackson, MS (onsite)
Experience: 1+ years
Employment type: Full time
Pay: Hourly
FTE: 100%
Work shift: Day
FLSA designation: No
Grant funded: No
Job posting date: 10/7/2026

View full job page →

12d ago

Medicaid Data Analyst - State Program Administrator Coordinator

State of Minnesota - Human Services Dept St. Paul, MN

St. Paul, MN

12d ago

$37 - $56/hr Full time Analytics Business Intelligence Data Analysis

Apply Now

Job Description

The State of Minnesota, Department of Human Services (DHS) is seeking a Medicaid Data Analyst to support statewide data and fiscal analysis within the Financial Operations Division (FOD). In this hybrid role based in St. Paul, you will lead statistical research and public integrity oversight efforts for Medicaid and other Health Care and Housing programs.

You will build and refine analytics that support risk, fraud, and non-compliance detection, develop reporting for internal and external stakeholders, and coordinate large-scale data work with counties, tribes, and multistate agencies to align with DHS fiscal and strategic goals.

What you will do

Develop, maintain, and improve models to identify and predict potential risk, fraud, and non-compliance in the Medicaid program.
Create Tableau dashboards and reports so internal and external partners can use the models and resulting analysis.
Lead and coordinate development and implementation of Federal Medical Assistance Percentage (FMAP) opportunities by delivering data analysis and presentations to senior management.
Serve as the primary data expert and produce complex data used for the annual Human Service Cost Report, supporting counties, tribes, legislators, and other stakeholders with data spanning services provided under policy housed at both DHS and DCYF.
Coordinate, prioritize, and complete data requests from auditors, media, and other interested parties.
Support internal requests for ad hoc data mining, data coordination, and other special projects assigned by Financial Operations leadership.

Required qualifications

Three (3) years of experience developing and implementing system and data collection objectives, specifications, and methodologies.
Comprehensive knowledge of the MMIS/MAXIS/METS/SSIS data system (or a similar eligibility system for public assistance and health care), including data structure, data relationships, and processes.
Experience extracting data from data warehousing using SAS or SQL across multiple applications.
Experience providing data and other information for auditing purposes.
Experience creating dashboards, reports, and other methods to synthesize analytic results.
Knowledge of Generally Accepted Accounting Principles (GAAP) and State Wide Integrated Financial Tools (SWIFT) (or similar electronic accounting systems).
Understanding and experience in federal financial reporting.
DHS will conduct reference checks to verify job-related credentials and a criminal background check prior to appointment.

Technologies

Tableau
SAS
SQL
MMIS, MAXIS, METS, SSIS
SWIFT
GAAP

Telework

Telework is eligible for applicants who reside in Minnesota or a bordering state, with supervisory approval and satisfactory performance.
If you live in a bordering state, you must live 50 miles or less from the primary work location to be eligible.

Benefits

Paid vacation and sick leave
12 paid holidays each year
Low-cost medical, dental, vision, and prescription drug plans
Fertility care, including IVF
Diabetes care
Dental and orthodontic care for adults and children
6 weeks paid leave for parents of newborn or newly adopted children
Pension plan (after working at least three years)
Employer-paid life insurance
Short-term and long-term disability insurance
Tax-free expense accounts for health, dental, and dependent care
Resources supporting physical, emotional, social, and financial well-being
Training, classes, and professional development
Tuition reimbursement
Federal Public Service Loan Forgiveness Program (some positions may qualify)
Employee Assistance Program (EAP) for work/life support
Daily Living/Convenience Services: chore services, home repair, trip planning, and child/elder care

Preferred qualifications

Experience extracting data from the DHS Data Warehouse.
Knowledge of the Minnesota Government Data Practices Act (MGDPA).
Experience designing, administering, and troubleshooting data models in a relational database system.
Knowledge and experience with state and federal assistance programs and resulting data systems, especially MMIS.
Understanding of how local, state, federal, and community agencies interact in public program administration.
A Bachelor’s or Master’s degree in social science, data science, analytics, research, public administration, accounting, finance, or a related field.
Varied experience working effectively with others from different backgrounds and cultures.

Additional information

This position is designated in the Connect 700 Program for applicants with disabilities.
DHS is unable to provide sponsorship for work visas; applicants must be eligible to work in the United States at the start of employment.
DHS does not participate in E-Verify.

How to apply

Select “Apply for Job” at the top of this page.
If you have questions about applying, contact the Careers Help Desk at 651-259-3637 or email careers@state.mn.us.
Additional application process information is available at http://www.mn.gov/careers.

Contact

For questions about this position, contact Rebecca Path at Rebecca.Path@state.mn.us.
To be considered as a Connect 700 Program applicant, apply online and email the Job ID#, the Working Title, and your valid Proof of Eligibility Certificate by the closing date to Alexander Duren at alexander.duren@state.mn.us.
For ADA accommodations for an interview, contact the DHS ADA Coordinator at 651-431-4945 or DHS_ADA@state.mn.us.

Location: St. Paul, MN (hybrid) | Pay: USD 37 to 56 per hour | Minimum experience: 3 years

View full job page →

Medicaid Fraud And Compliance Data Jobs

Data Analyst - 340B Compliance

Medicaid Data Analyst - State Program Administrator Coordinator

Get Medicaid Fraud And Compliance Data Jobs alerts