AGO Senior Investigator/Analyst (Internal Only) | Medicaid Fraud & Abuse Division | Olympia

State of Washington•Thurston County – Olympia, WA

3d•Hybrid

About The Position

The Attorney General’s Office is recruiting for a permanent full time AGO Senior Investigator/Analyst (Senior Special Agent - Intake) in the Medicaid Fraud & Abuse Division. This position is located in Olympia, Washington, and is represented by the Washington Federation of State Employees (WFSE). The work of the Office’s Medicaid Fraud & Abuse Division (MFA) focuses on both criminal and civil law enforcement. The 75% federally funded MFA‘s mission is combating provider fraud, abuse and neglect in residential facilities and involving Medicaid recipients in non-institutional settings. MFA’s Headquarters is located in Olympia, Washington with some team members also located at the AGO's Spokane Office and Seattle Office. The Division currently has a staff of 83 FTEs, including attorneys, special agents, data scientists, clinical health investigators and professional support staff. MFA involves protecting not only the Medicaid program of roughly $24 billion per annum, but also its most vulnerable persons, typically elderly persons in residential facilities or persons abused or neglected by a Medicaid Provider. In many of our cases, there is no precedent, so MFA is consistently on the cutting edge of legal theories and issues. The cases range from abuse and neglect of people in nursing homes, large scale organized individual and corporate civil and criminal fraudulent activity to national whistleblower actions. Our staff is a highly professional, fun and seasoned analytical investigative team. MFA is unique in that all cases have an attorney, special agent, data analyst assigned with legal support. This, and the great people who make up the division, gives MFA a particularly terrific team atmosphere.

Requirements

This position is open to current permanent employees of the Washington State Office of the Attorney General only.
Bachelor’s degree and ten (10) years of experience conducting investigations, which include the authority to independently plan and conduct investigations in civil or criminal cases.
OR Five (5) years’ experience as an AGO Investigator/Analyst.
Additional qualifying investigative experience may substitute year for year for education.
A background check consisting of employment history, professional references and educational verification (e.g., degree, license, or official transcript) may be conducted.
Prior to any offer, the applicant selected will be required to submit to and pass a fingerprint-based criminal background check conducted by the Washington State Patrol, Criminal Records Division.
The incumbent will submit to additional background checks as a condition of employment every five (5) years thereafter.

Responsibilities

Coordinate and process all allegations received by MFA.
Review all allegations to determine whether the matter alleged falls within the jurisdiction of MFA.
Work with a Managing AAG to provide further review and consultation.
Process each allegation pursuant to the MFA Intake Policy.
Act as a liaison with RCS and APS Referral sources providing training, information, and guidance regarding referrals.
Capture and reporting metrics relating to allegations.
Ensure the intake team desk reference manual and relevant operational policies are current and address the MFA allegation processing requirements in a timely and efficient manner.
Develop and deliver training and outreach.
Investigate and coordinate highly complex civil and criminal healthcare fraud matters which are of a serious or sensitive nature and are assigned under the oversight of the assigned AAG.
Carry an intake and assessment investigative case load and joining open investigative teams as needed.
Follow up with local law enforcement, other agencies and the public on allegations.
Create investigative plans and participate as a team member on assigned cases working with the assigned assessment AAG and medical services section/data scientists team members.
Work with federal, local and Washington State law enforcement agencies as required under 42 USC §1396(b)(q), 42 USC §1007 et seq.
May lead multi-jurisdictional investigations relating to Medicaid provider fraud, abuse and neglect of vulnerable adults.
Develop sources of information relating to Medicaid fraud and abuse and neglect in residential facilities.
Execute search warrants.
Collect, preserve and handle evidence in accordance with established rules of evidence.
Conduct surveillance.
Conduct criminal and civil interviews.
Prepare written reports, affidavits and other investigative documents.
Serve as a subject matter expert in civil and criminal healthcare fraud investigations.
Identify, seek out and participate in key stakeholder relationships and other multi-jurisdictional investigative task force/working groups as determined by the Director.
Attend key shareholder meetings, multi-jurisdictional law enforcement and social welfare agency task force/working group meetings.
Establish and maintain good working relationships with administrative agencies and law enforcement.
Act as a liaison with those agencies to ensure the referral of and requests for assistance and training regarding suspected fraud and abuse are delivered by the MFA.

Benefits

Medical/Dental/Vision for employees & dependent(s)
Vacation, Sick, and Other Leave
11 Paid Holidays per year
Public Employees Retirement System (PERS) plans
Life Insurance
Dependent Care Assistance
Flexible Spending Accounts
Public Service Loan Forgiveness
Tuition Waiver
Deferred Compensation
Employee Recognition Leave
Flexible schedules
Part-time/hybrid telework options
A Wellness Program
Infants in the Workplace Program
Employee Assistance Program, which provides counseling, webinar, and other cost-free support resources
Numerous employee-driven affinity groups to foster community and connection, including Bereavement, Elder Care, Parenting, POC, LGBTQ+, Veterans and more.