Title: Forensic Accountant
Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.
AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry.
Come join our dynamic and dedicated team.
Office of Inspector General (OIG)
Address: 801 E. Jefferson Street, Phoenix, AZ 85034
Salary: $62,000 - $72,000
Position will remain open until filled
The position is responsible for conducting complex financial analysis and documenting findings. Will manage caseloads and assist all of the Office of Inspector General (OIG) operational units as needed. The position is expected to conduct interviews and provide expert, fact, and summary testimony as needed.
Major duties and responsibilities include but are not limited to:
* Conduct analysis of complex financial and business records to support investigations and/or prosecutions; Review and analyze financial transactions in order to accurately identify all parties involved in criminal activity. Use financial analytical skill sets to audit, investigate, and analyze all components of a financial infrastructure.
* Perform complex performance, operational and financial reviews or audits including, but not limited to reconciliation of Center for Medicare and Medicaid Services (CMS) reporting of overpayment recoveries and penalties with Division of Business Finance (DBF) and the case management database system quarterly.
* Prepare letters and documents for investigators and management of analytical and audit results; and any identified financial, operational, and administrative vulnerabilities related to the investigation.
* Interpret complex laws, rules, and regulations regarding program integrity audits as well as conduct operational and financial risk assessments.
* Under the guidance of the Forensic Accounting Manager, will represent OIG for the CMS contractors for the Fee-For-Service (FFS) system and will represent OIG with a delegated responsibility to ensure the CMS managed care contracting process and later implementation is in accordance with program integrity requirements.
* Provide staff support to reconcile internal controls, perform internal control reviews, program integrity audits, and other investigations to support OIG programs.
* Draft internal letters which are substantiated with documented findings and it may participate and/or direct activities during sensitive internal control reviews and investigations.
* Generally Accepted Government Auditing Standards (GAGAS)
* Performance and operational auditing guidelines in health care
* Program integrity rules, regulations, guidelines and standards within Medicaid
* Organization’s operations including contracted public/private service providers and related financial systems and records
* Able to determine compliance with applicable Medicaid statutes, regulations, policies, and procedures for auditing purposes
* Medical claim billing systems
* Financial accounting practices and systems
* Internal control principles or internal audit standards
* Generally Accepted Accounting Practices
* Government accounting practices, performance and operational auditing, and financial reporting
* Federal and State regulations, statutes, and Agency policies and procedures regarding Medicaid and Medicare
* Technical, computer systems and related software
* Effective interpersonal communications, oral, and written
* Logical, sequential, analytical reasoning
* Database and spreadsheet applications such as Microsoft Access and Excel
* Research and analysis, Problem solving, Critical Thinking, Financial Reconciliation processes
* Oral and written communication
* Organization and time management
* Analyzing difficult situations and developing a clear plan to address unique situations
* Applying and interpreting Federal and State laws, rules and regulations
* Applying auditing and accounting methods and techniques
* Analyzing, interpreting, and communicating financial data
* Conduct Financial Analytical accounting and audit functions with an understanding of accounting principles as well as administrative functions
* Accept and respond to direction and feedback
* Perform strong research skills
* Synthesize complex audit and accounting findings
* Conduct and reconcile internal audits, such as forfeiture funds
* Perform accurate and timely work with minimal supervision
* Interpret and explain financial, forensic and administrative accounting information
* Work in a team based environment, and take initiative
* Plan, summarize, and analyze large amount of complex accounting information and data, and be able to present information in a clear and concise fashion
* Operate a State Vehicle
* Successfully function in a virtual environment
Arizona Drivers License.
* Bachelor’s Degree in accounting or closely related field OR three years’ experience as an Auditor or equivalent.
* Certified Fraud Examiner Certification (CFE) or Certified Public Accountant (CPA).
* Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees.
* Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.
* Travel is required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.) AND have an acceptable driving record for the last 39 months including no DUI, suspension or revocations and less than 8 points on your license. If an Out of State Driver License was held within the last 39 months, a copy of your MVR (Motor Vehicle Record) is required prior to driving for State Business. Employees may be required to use their own transportation as well as maintaining valid motor vehicle insurance and current Arizona vehicle registration; however, mileage will be reimbursed.
If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.
All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
Among the many benefits of a career with the State of Arizona, there are:
* 10 paid holidays per year
* Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
* Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
* Other Leaves - Bereavement, civic duty, and military.
* A top-ranked retirement program with lifetime pension benefits
* A robust and affordable insurance plan, including medical, dental, life, and disability insurance
* Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
* RideShare and Public Transit Subsidy
* A variety of learning and career development opportunities
By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.
Lifetime Pension Benefit Program
* Administered through the Arizona State Retirement System (ASRS)
* Defined benefit plan that provides for life-long income upon retirement.
* Required participation for Long-Term Disability (LTD) and ASRS Retirement plan.
* Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period).
Deferred Retirement Compensation Program
* Voluntary participation.
* Program administered through Nationwide.
* Tax-deferred retirement investments through payroll deductions.
Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing email@example.com.
Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.