Job Description

Recruitment InformationRecruitment Number 24-0213THIS JOB POSTING WILL REMAIN OPEN UNTIL 20 APPLICATIONS ARE RECEIVED.
PLEASE APPLY IMMEDIATELY AS THIS RECRUITMENT MAY CLOSE AT ANY TIME.The current vacancy position is a permanent full-time position.Salary: $5,076 to $6,177 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.Duties SummaryThe 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.Minimum Qualification RequirementsTo 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 analysis such as using data mining, data or database queries, statistically valid samplings, etc., of information or data such as health care providers\' billings, diagnosis codes, procedural codes, health care provider information, etc.; statistical and quantitative analysis methods to determine cause and effect; computer applications including data analysis and statistical applications (e.g., LexisNexis Intelligent Investigator, IBM Cognos, SAS, Access, Excel, etc.); and the skill to interpret and summarize such data, information and findings; prepare clear and concise reports of findings; and organize large data sets with accuracy and attention to detail.Therefore, certification of eligibles for this position shall be restricted to those applicants who meet the minimum qualification requirements for the class General Professional IV. In addition, at least one (1) year of General Experience required for the class MUST demonstrate the knowledge and skills described above.Such Med-QUEST Data Analyst Experience may have been gained concurrently with, or in a separate capacity from, the aforementioned General Experience.Supervisory Aptitude: Supervisory aptitude rather than actual supervisory experience may be accepted. This requirement will be considered to have been met when there is strong affirmative evidence of the necessary supervisory abilities and/or potential.Substitution Allowed: Relevant substitution as described in the Minimum Qualification Requirements, will apply.
This does not apply for the Med-QUEST Data Analyst Experience.The information provided above represents a summary of the complete Minimum Qualification Requirements. To view the Requirements in their entirety, please .02006:020612:13:ASOther InformationThe State of Hawai\'i complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If you require reasonable accommodations in completing an application, any pre-employment testing, or otherwise participating in the selection process, please call 808-587-0936 for assistance.PUBLIC SERVICE LOAN FORGIVENESS (PSLF) PROGRAM
The PSLF Program is a federal program that is intended to encourage individuals to work in public service by forgiving the balance of their federal student loans. To qualify, the individual must have made 120 qualifying payments while employed by a qualifying employer. For more information, please click:ELECTRONIC NOTIFICATION TO APPLICANTS
The Department of Human Resources Development (HRD) will use electronic mail (email) to notify applicants of important information relating to the status and processing of their applications as part of our ongoing efforts to increase operational efficiency, promote the conservation of green resources, and minimize delays and costs.Please ensure that the email address and contact information you provide is current, secure, and readily accessible to you. We will not be responsible in any way if you do not receive our emails or fail to check your email-box in a timely manner. In addition, please be aware that you may no longer receive notification about applications submitted if you choose to disable the Job Application Emails feature in your Account Settings.TESTING INFORMATION
The examination for this recruitment will be conducted on an unassembled basis where the examination score is based on an evaluation and rating of your education and experience. It is therefore important that your employment application provide a clear and detailed description of the duties and responsibilities of each position you held.In-person interviews and/or further testing in Hawaii may be required at the discretion of the hiring agency. If in-person interviews and/or further testing is a requirement, applicants who meet the minimum qualification requirements and are referred to the vacancy must be available to participate in person and at their own expense in this required phase of the selection process.Applicants are encouraged to submit their applications as soon as possible. In addition to employment availability and score, the referral of qualified applicants may be based upon other factors including date of receipt of application.for Important Information about Equal Employment Opportunity, the Merit Civil Service System, Citizenship and other requirements, Reasonable Accommodation, Veterans Preference, Examination Requirements, and the State Recruiting Office\'s Levels of Review.

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