Investigative Analyst

TX-HHSC-DSHS-DFPS • Fort Worth, TX

1d • Hybrid

About The Position

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.

The Office of Inspector General-Benefits Program Integrity (OIG-BPI) Investigative Analyst-Investigator III is selected by and reports to the Regional Manager. The position performs moderately complex administrative investigations for individuals who have obtained excess benefits from the HHS programs they were ineligible to receive. The Investigative Analyst Investigator III is responsible for investigating referrals of fraud, waste, and abuse by HHS clients; conducting thorough research and evidence gathering activities; and determining whether the information collected represents a violation of program laws, rules, or regulations according to applicable evidentiary standards.
The Investigative Analyst-Investigator III ensures that allegations of client fraud, waste, or abuse are investigated according to law, regulations, agency policies, and professional standards. The position reviews and analyzes records and reports from multiple agency, state, and federal databases; collaborates with both internal and external stakeholders to obtain verification and evidence; understands and applies relevant eligibility requirements; and calculates and establishes overpayment claims. The position obtains business records affidavits, submits subpoenas, and coordinates with law enforcement or other state and federal entities. The Investigative Analyst will prepare evidence and testify during Administrative Hearings. The Investigative Analyst assists the Regional Field Investigations Team with researching fraud and non-fraud investigations by screening complaints, accurately determining the type of investigations, identifying contacts and potential witnesses, contacting subjects, employers, or collaterals to verify recipient case information. The Investigative Analyst assists with interpreting policy, training and coordinating regional intern staff, and responding to complaints.
The position assists with preparing and presenting training, coordinates with BPI leadership to develop and implement improvements to BPI’s investigative processes to improve efficiency and promote program integrity, and performs other related duties as assigned. Works under general supervision with moderate latitude for the use of initiative and independent judgment as governed by policy and procedures.
This position will also provide backup administrative support for the Regional Field Investigations Team as needed.
This role allows for some telework flexibility.

Requirements

• Knowledge of policies, procedures, rules, regulations and Health and Human Services programs.
• Knowledge of OIG policy, HHS/AES policy, and appropriate use of the ASOIG and THCR system.
• Knowledge of office management and administrative procedures.
• Knowledge of investigative principles, techniques, and standards.
• Knowledge of hearing procedures, practices, and rules of evidence.
• Knowledge of state and federal laws, regulations, and policies related to Health and Human Services, particularly related to Claims and SNAP program disqualifications.
• Knowledge of HHS social services programs and eligibility requirements.
• Knowledge of skill in interviewing clients.
• Skill in communicating effectively both orally and in writing.
• Skill in conducting legal research and analysis.
• Skill in the use of computer/laptop equipment and applicable software applications.
• Skill in performing budget calculations and using mathematical formulas.
• Skill in handling multiple competing priorities and meeting deadlines.
• Skill in conducting quality assurance on investigative cases of clients participating in HHS programs and conducting case readings.
• Skill in developing sources of information.
• Skills in Microsoft Word and Excel to analyze data and produce moderately complex reports.
• Ability to establish and maintain effective working relationships with others.
• Ability to organize research and gather evidence.
• Ability to conduct interview and gather facts.
• Ability to interpret and apply laws and regulations.
• Ability to assess situations encountered during an investigation and take appropriate actions.
• Ability to plan, organize, and conduct investigations.
• Ability to conduct investigative interviews.
• Ability to communicate effectively with a variety of individuals.
• Ability to comprehend agency policies and guidelines and determine employee or recipient compliance.
• Ability to compile, evaluate findings, and present information relevant to investigations.
• Ability to use facts to prepare high-quality reports with strong attention to detail.
• Ability to testify in hearings proceedings and guide others through the process.
• Ability to mentor interns.
• Ability to develop and present training to others.
• Ability to conduct diverse investigations with minimum supervision.
• Experience with Streamline reporting (SR) and Change Reports.
• Experience in using automated systems for documentation, research, and tracking.
• Graduation from an accredited high school or GED.
• Graduation from an accredited four-year college or university with major coursework in business, public administration, criminal justice, computer science or a related field OR four years’ experience of criminal or administrative investigations OR five years administrative experience with a demonstrated background in conducting research, creating reports, conducting civil or administrative research involving SNAP, TANF, WIC, and Medicaid programs is required.
• Current, Valid Driver’s License Required

Responsibilities

• Assists the Regional Field Investigations Team with researching investigative assignments by screening complaints, accurately determining the type of investigations, identifying contacts and potential witnesses, contacting subjects, employers, or collaterals to verify recipient case information.
• Researches, collects evidence, reviews records, and examines potential eligibility discrepancies through multiple agency, state, and federal systems to determine program compliance and identify fraud.
• Interacts and exchanges information with various internal and external stakeholders; and contacts and interviews witnesses and complainants as appropriate to verify recipient case information and evaluate allegations of fraud, waste, and abuse.
• Assists the Regional Director with intern training, coordination, and oversight.
• Conducts investigations of alleged violations of laws, rules, and regulations, as well as background and personal history investigations, ensuring that investigative activities are conducted according to federal and state laws, regulations, and requirements.
• Follows HHS and OIG policies and procedures and adheres to applicable investigative standards and evidentiary protocols.
• Evaluates, summarizes, and documents investigative findings and prepares detailed, factual investigative case reports.
• Calculates overpayments and establishes overpayment claims to recover unauthorized benefit payments.
• Prepares correspondence to clients detailing investigative outcomes and provides testimony and presents case file information and evidence at administrative hearings.
• Maintains clear investigative documentation and implements well-organized electronic filing and documentation systems.
• Employs organizational techniques to manage a high volume of investigations at various stages simultaneously.
• Suggests process improvements that increase efficiency and effectiveness of investigative activities and documentation.
• Adheres to confidentiality requirements and records retention schedules.
• Performs administrative or support work for the assigned regional team and makes recommendations for work standards and procedures.
• Provides backup administrative support for the BPI Regional Investigations Team as needed.
• Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.

Benefits

• Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED