GENERAL PROFESSIONAL IV (MED-QUEST DATA ANALYST) - EWA, OAHU

Posting number: 26-0295

Department: Human Services

Job classification: GENERAL PROFESSIONAL IV (SR-22)

Posting type: Open

Categories: Health Services, IT and Computers, Social Services, Investigative, Professional, Human Services, Research

Summary

Recruitment Number 26-0295 - The current vacancy position is a permanent, full-time position with the Department of Human Services, Med-Quest Division. 

THIS JOB POSTING WILL REMAIN OPEN UNTIL 40 APPLICATIONS ARE RECEIVED.
PLEASE APPLY IMMEDIATELY AS THIS RECRUITMENT MAY CLOSE AT ANY TIME.

Salary: $5,527 to $6,728 per month (SR-22, Step D to I)    

Note: Hiring rates will be based on availability of funds, the applicant's qualifications, and other relevant factors.

Examples of duties

The General Professional IV independently performs complex professional work which involves considerable research and analysis of a variety of issues, identification of various options and recommendation of the most viable solution.

This position is located in the Department of Human Services, Med-QUEST Division (MQD), Finance Office, and is responsible for conducting data analysis in support of the Division's statewide surveillance and utilization control program of program integrity functions to identify potential fraud and abuse by Medicaid program providers.

The duties and responsibilities of this position include analyzing and evaluating surveillance and utilization review subsystem reports, providers' records, claims and other related materials, current trends in provider abuse and fraud, complaints against providers, etc., to determine the scope, parameters and variables for data analyses; analyzing and interpreting any identified anomalies, aberrancies, outliers, etc., and verifying or corroborating with data, records, claims, files, program providers, etc., to determine whether the utilization of services and providers' claims and billings represent potential fraud and abuse; referring cases involving possible fraud and abuse for preliminary investigation by MQD investigative staff; preparing summaries and reports with data; maintaining accurate and updated fraud and abuse reports, records, and referrals; and performing other related duties as assigned.

Qualifications

To qualify, you must meet all of the following requirements:

Legal Authorization to Work:

The State of Hawaii requires all persons seeking employment with the government of the State shall be citizens, nationals, or permanent resident aliens of the United States, or eligible under federal law for unrestricted employment in the United States.

Basic Education: Bachelor's degree from an accredited four-year college or university.

General Experience: One (1) year of responsible professional work experience which required a high degree of analytical skill. Such experience must have involved gathering, evaluating and analyzing facts and other pertinent information required to resolve problems and/or to determine and recommend appropriate courses of action; demonstrated the ability to elicit information orally and in writing; reading, comprehending, interpreting and evaluating technical subjects, analysis or proposals; and applying problem solving methods and techniques, such as defining and analyzing problems, identifying alternative courses of action, using judgment in determining appropriate alternatives; and preparing clear and concise written reports and recommendations for action.

The experience must have been comparable to the General Professional III in the State service and must have provided the knowledge, skills and abilities required to perform the duties and responsibilities of the position to be filled.
The General Professional III independently performs moderately complex professional work which involves performing research and analysis in order to identify problems and recommend appropriate solutions in accordance with established policies, procedures, standards, guidelines, techniques and methods.

Selective Certification Requirement (Med-QUEST Data Analyst Experience): In order to effectively perform the duties and responsibilities of this position, applicants must possess demonstrated knowledge of methods and tools of data analysi