Investigator II

State of Delaware•Dover, DE

20h

About The Position

This Investigator II role supports Delaware's Paid Family and Medical Leave insurance program established under the Healthy Delaware Families Act. You will serve as a primary point of contact for claimants, ensuring claims are processed efficiently, fairly, and in compliance with the Act and applicable regulations. Key responsibilities include investigating and resolving claim issues, discrepancies, and claimant concerns; maintaining detailed and accurate records; reviewing claims to verify eligibility; and identifying potential fraud. Success in this role will involve customer service and organizational skills; the ability to manage a high-volume caseload; attention to detail to identify suspicious activity; proficiency with automated systems; and a commitment to equitable and consistent administration of the Delaware PFML program.

Requirements

One year of experience in conducting investigations which may include conducting interviews to obtain confidential information, gathering evidence, and documenting findings.
One year of experience in collecting, evaluating and analyzing relevant information to make recommendations on alleged or probable violations of state or federal laws, rules and regulations.
One year of experience in providing clear, prompt and accurate information to respond to and resolve complaints.
Six months' experience in civil, criminal or administrative proceedings such as providing testimony before boards/commissions/authorities, preparing evidence/sworn statements, or managing and prioritizing cases.

Responsibilities

Conducts investigations of alleged or probable violations or compliance issues by identifying, obtaining, verifying, and analyzing relevant information or evidence.
Collects, controls, and evaluates evidence such as physical, financial, background, and other records, documents and items.
Formulates questions and conducts interviews to obtain information and ascertain facts from witnesses, complainants, victims or other parties.
Interprets, explains and ensures compliance with applicable state and federal laws, rules, regulations, standards, policies, and procedures.
Makes judgments after evaluating all available facts and recommends appropriate action to authorities, commissions, or technical supervisors, and may take enforcement action as necessary.
Uses commercial and proprietary automated information systems, computer software, and the internet to research, document, verify and report on investigative/intelligence data and related information.
Documents details of all calls, emails, inquiries, interviews, and other interactions during the investigation and may be assigned to respond to hotlines.
Prepares and submits investigative reports that clearly and accurately document findings, supporting facts, and action taken.
Testifies and presents evidence before boards, commissions, administrative bodies, or courts.
Delivers excellent customer service to internal and external customers and the public in person, electronically, or by written communication.
Communicates and interacts effectively with people across cultures, ranges of ability, genders, ethnicities, ages, and races.
May conduct surveillance, undercover investigations, and on-site inspections on assigned cases; and may make arrests or obtain search warrants pertaining to an investigation.
May make recommendations to subpoena information.