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Recruitment #19-005482-0002




MDH, Office of the Inspector General, Baltimore, MD

Main Purpose of Job

This position is a unique executive level position in state service with primary responsibility for managing the Division of Program Integrity. In this capacity this position is responsible for creating and effectively managing the resources that target and identify trends and patterns of fraud, abuse and over payments of providers within the Medicaid program or fraud, waste or abuse with regards to recipient eligibility for the Medical Assistance Program. The unit ensures that Medicaid Program resources are expended in accordance with State and Federal laws and regulations. The unit is responsible for investigation of recipient fraud for the purpose of seeking criminal prosecution for violations of law and for the purpose of maximizing the recovery of monies spent for Program benefits for which there were no entitlement.

The Division of Program Integrity is divided into Provider Reviews, and Recipient Reviews and Data Analysis (RRDA). The RRDA is further divided into Recipient Medicaid Fraud Reviews, Data Analysis, Clinical, and Special Projects. The Division of Program Integrity also assumed responsibility for the Recovery Audit Contractor.

The Division of Provider Program Integrity conducts audits, investigations, and billing reviews of private providers who receive payment from MDH/Medicaid for services provided to MDH/ Medicaid clients. Federal law requires States to make efforts to detect and prevent improper payments to such provider.  This position oversees program managers, supervisors, auditors, investigators and clinical staff dedicated to Program Integrity efforts.

This position is the point of contact for the Medicaid Fraud Control Unit and the new Program Integrity Unit with-in, the Centers for Medicare and Medicaid Services (CMS).


Qualified candidates will possess a Bachelor's degree from and accredited college or university.  (A Juris Doctorate is preferred.)  Qualified candidate will also possess 6 years of accounting/financial management or similar experience, including 3 years of supervisory experience.   Professional experience must include work in fraud investigation/prevention, and/or conducting financial audits.


Desired candidates should possess:

  • Skill in managing and coordinating multiple tasks/complex reporting assignments
  • Ability to supervise staff, monitor performance, implement improvements and communicate effectively
  • Law background preferable
  • Experience with the Maryland Medicaid Program


This is a Management Service position, and serves at the pleasure of the Appointing Authority.  A resume must accompany your application.

Applicants who meet the minimum (and selective) qualifications will be included in further evaluation. The evaluation may be a rating of your application based on your education, training and experience as they relate to the requirements of the position. Therefore, it is essential that you provide complete and accurate information on your application. Please report all related education, experience, dates and hours of work. Clearly indicate your college degree and major on your application, if applicable. For education obtained outside the U.S., any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview). 

Complete applications must be submitted by the closing date. Information submitted after this date will not be added. 

Candidates may remain on the certified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.



Online applications are highly recommended. However, if you are unable to apply online, the paper application (and supplemental questionnaire) may be submitted to MDH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201. Paper application materials must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.

If additional information is required, the preferred method is to upload.  If you are unable to upload, please fax the requested information to 410-333-5689. Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time.

For questions regarding this recruitment, please contact the MDH Recruitment and Selection Division at 410-767-1251.

If you are having difficulty with your user account or have general questions about the online application system, please contact the MD Department of Budget and Management, Recruitment and Examination Division at 410-767-4850 or

Appropriate accommodations for individuals with disabilities are available upon request by calling: 410-767-1251 or MD TTY Relay Service 1-800-735-2258.

We thank our Veterans for their service to our country.

People with disabilities and bilingual candidates are encouraged to apply.

As an equal opportunity employer, Maryland is committed to recruitment, retaining and promoting employees who are reflective of the State's diversity.