Data Science & Informatics Specialist 1, Medicaid ...

Position and SalaryThe Attorney General’s Office is recruiting for a permanent full time Data Scientist in the Medicaid Fraud Control Division. This position is located in Olympia, Washington, and is represented by the Washington Federation of State Employees (WFSE).Data Science & Informatics Specialist 1 Salary Range 68: $84,984 - $114,264. 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 AGO provides a workplace that is understanding of work-life balance and promotes advancement by offering a wide variety of professional development and growth opportunities.Excellent benefits: Washington State offers one of the most competitive benefits packages in the nation, including Medical/Dental/Vision for employees & dependent(s); Vacation, Sick, and Other Leave; 11 Paid Holidays per year; Public Employees Retirement System (PERS) plans; and Life Insurance. Beyond these traditional benefits, we offer Dependent Care Assistance, Flexible Spending Accounts, Public Service Loan Forgiveness, Tuition Waiver, Deferred Compensation, Employee Recognition Leave, and more. We also offer a Wellness Program and related resources. Flexible schedules and part-time/hybrid telework options.A Wellness Program, an Infants in the Workplace Program, and the Employee Assistance Program, with counseling, webinars, and other cost-free support resources.Numerous employee-driven affinity groups to foster community and connection (e.g., Bereavement, Elder Care, Parenting, POC, LGBTQ+, Veterans).About the Medicaid Fraud Control Division (MFCD)The MFCD focuses on criminal and civil law enforcement. It is a 75% federally funded division whose mission is to combat provider fraud, abuse, and neglect in residential facilities and involving Medicaid recipients in non-institutional settings. MFCD Headquarters is in Olympia, with team members in the Spokane and Seattle offices. The division currently has about 60 FTEs, including attorneys, auditors, special agents, data analysts, clinical health investigators, and professional support staff.MFCD protects the Medicaid program (roughly $13 billion per year) and vulnerable persons, often elderly in residential facilities or those abused or neglected by a Medicaid provider. Cases range from abuse and neglect to large-scale fraud and national whistleblower actions. Our staff is highly professional and collaborative, with attorneys, special agents, data analysts and legal support assigned to each case, creating a strong team atmosphere.Duties and Essential Functions of a Data Science & Informatics Specialist 1Perform research, querying, and analysis of complex Medicaid claim and encounter data; review financial, billing and healthcare records to identify trends, anomalies, and patterns indicative of fraud.Assist in designing, writing and executing data queries using SQL and other programming languages to query Medicaid data.Assist in the design and implementation of advanced statistical models and data algorithms.Assist in investigative steps to identify, research and assess allegations of fraudulent billings and/or other issues.Use developed SQL queries and software applications to conduct complex quantitative and qualitative analysis to identify potential fraud schemes for case development.Analyze complex healthcare service claim data to determine utilization related to complaints/allegations and respond to data requests.Research Medicaid billing and program guides, policies, state and federal regulations; payment methodologies; billed medical, dental and social services procedures and applicable codes.Research and understand medical coding systems and guidelines (CPT, HCPCS, ICD, DRG, EAPG, etc.) and apply codes to identify billing and coding irregularities.Examine, analyze and research financial and billing documents and healthcare records obtained during intake or from search warrants and Civil Investigative Demands.Collaborate with senior data scientists to review analytical reports, spreadsheets, data visualizations, and associated documents.Maintain all reports and pertinent documentation in electronic format.There will be a full training program to assist you in becoming familiar with the data and how to query Medicaid data. If you’re looking for a great place to work with a positive environment, this is the job for you!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.QualificationsBachelor’s degree in informatics, data science, mathematics, computer science, statistics, biostatistics, epidemiology, or related technical/quantitative field, and one (1) year of experience performing data science or informatics data work. Experience in a specialty area such as public health or healthcare and/or experience with data visualization software and programming may be desired. Additional qualifying experience may substitute year for year for required education.Preferred Certification: CPA, AFE, or CFESkills and AbilitiesProficiency with Microsoft Excel, including developing complex spreadsheets with macros, multiple math functions, advanced filters, and links to external sources of information.Basic skills with medical coding terminology and systems (CPT, HCPCS, ICD9, ICD10).Basic knowledge of medical billings.Microsoft Word, Microsoft Outlook, Microsoft Access; and experience with Adobe Acrobat.Knowledge of RAT-STATS, SQL, and SAS is desirable.Knowledge of financial/data analytics.Conditions of Employment:The background check will include employment history, professional references, and educational verification. Prior to any offer, the applicant will undergo a fingerprint-based criminal background check by the Washington State Patrol, with additional checks every five years thereafter.About the Washington State Office of the Attorney GeneralThe AGO serves more than 230 state agencies, boards, commissions, colleges and universities, the Legislature and the Governor. The Office comprises nearly 700 attorneys and 800 professional staff, delivering high-quality legal services to Washington state officials and entities. The AGO focuses on economic justice, social justice, criminal justice, and more. The agency has national reach and invites you to learn more about the AGO here.Diversity and InclusionDiversity is critical to the AGO’s mission. We strive for an inclusive environment with diverse cultures and backgrounds. The AGO’s commitment includes recognition of awards and wellness achievements. Application InstructionsIn addition to the online application, please attach:A letter of interest describing your qualifications;A current resume detailing experience and education.Notes for ApplicantsReview your application for accuracy before submission.You may not reapply to this posting for 30 days.The initial screening will be based on work experience, education, completeness of the application, and responses to the supplemental questionnaire on resume will not substitute for completing the work experience section of the application.All information may be verified and documentation may be required.The AGO does not use E-Verify and does not sponsor OPT. For more information, visit Employment Opportunity and AccommodationsThe AGO is an equal opportunity employer and does not discriminate on various bases. Persons requiring reasonable accommodation in the application process or needing information in an alternative format may contact the recruitment team at . For hearing accommodations, contact the Washington Relay Service at 1-800-676-3777 or For questions, contact the recruitment team at . If you experience technical difficulties with the application, call NEOGOV at 855-524-5627 or email . #J-18808-Ljbffr

Created: 2025-10-03