INVESTIGATOR I, INVESTIGATOR II, AND INVESTIGATOR III
About The Position
Attorney General Andrea Joy Campbell is seeking highly motivated candidates to join her team in the role of Investigator in the Medicaid Fraud Division. The Investigator will conduct complex criminal and civil investigations into allegations of fraud and abuse committed by providers participating in the Medicaid program and allegations of abuse and neglect of residents in long-term care facilities or MassHealth members in health care settings. The Investigator will review complaints against providers; access Medicaid claims and conduct data analysis; research program rules and regulations; develop investigative plans; analyze financial records; review medical records; interview witnesses; conduct surveillance; serve subpoenas; help execute search warrants; draft interview and investigative reports and memos; collect and secure evidence; conduct public records searches; serve as a witness in criminal and civil proceedings; and perform other investigative tasks necessary to root out fraud, waste, and abuse. Some early morning or late evening hours may be required.
Requirements
- Bachelor’s degree or equivalent experience preferred.
- Investigator I: 0-2 years of relevant experience.
- Investigator II: 3-4 years of relevant experience.
- Investigator III: 5 or more years of relevant experience.
- Experience in at least one of the following areas: A background working on complex criminal or civil investigations, A background in health care compliance; fraud investigations; regulatory compliance; auditing; or accounting, A background working in healthcare such as (but not limited to): home health, pharmacy, dental, nursing, nursing homes, clinical laboratories, and/or ABA, Law enforcement experience at the local, state, and/or federal level.
- Experience using Microsoft Excel and Access preferred.
- Excellent organizational and analytical skills.
- Effective written and oral communication skills.
- Bilingual candidates are encouraged to apply.
- Must have access to reliable transportation or have a valid driver's license to travel as needed.
Nice To Haves
- Bachelor's degree or equivalent experience
Responsibilities
- Conduct complex criminal and civil investigations into allegations of fraud and abuse committed by providers participating in the Medicaid program.
- Conduct investigations into allegations of abuse and neglect of residents in long-term care facilities or MassHealth members in health care settings.
- Review complaints against providers.
- Access Medicaid claims and conduct data analysis.
- Research program rules and regulations.
- Develop investigative plans.
- Analyze financial records.
- Review medical records.
- Interview witnesses.
- Conduct surveillance.
- Serve subpoenas.
- Help execute search warrants.
- Draft interview and investigative reports and memos.
- Collect and secure evidence.
- Conduct public records searches.
- Serve as a witness in criminal and civil proceedings.
- Perform other investigative tasks necessary to root out fraud, waste, and abuse.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
