Investigator (AG)

State of careers Rhode Island

5d • $73,601 - $83,096 • Onsite

About The Position

The Rhode Island Office of the Attorney General is seeking a highly motivated investigator to join the Medicaid Fraud Control and Patient Abuse Unit (MFCU) to investigate complex criminal and civil enforcement actions related to allegations of fraud against the state Medicaid program and allegations of abuse and neglect of residents of long-term care facilities.

The Attorney General is the state’s top lawyer and law enforcement official, protecting and serving the people and interests of Rhode Island through a broad range of duties. Every day, the Office’s attorneys fight to ensure the public safety of the state’s communities, improve the economic security of its citizens, safeguard the state’s spectacular natural resources, and restore the public’s trust in government. Assistant and Special Assistant Attorneys General represent the people of Rhode Island in civil and criminal matters before trial courts, appellate courts, and the supreme courts of Rhode Island and the United States. The Office is unique among attorneys general offices across the country. Out of fifty states, only two other offices share the same broad criminal mission. The Office’s attorneys prosecute complex and violent crimes but also functionally serve as one of the nation’s largest district attorney’s offices, prosecuting all felonies throughout the state.

The mission of the Medicaid Fraud Control Unit (MFCU) for the State of Rhode Island is to investigate and prosecute fraud in the administration of the Medicaid program in Rhode Island, in the provision of medical assistance, or in the activities of providers of medical assistance pursuant to the Medicaid Program. Further, the MFCU seeks to protect residents or patients in health care facilities by investigating and prosecuting allegations of abuse and neglect. The MFCU is responsible for investigating and prosecuting (a) fraud by healthcare providers in the Rhode Island Medicaid program; (b) fraud in the administration of the Rhode Island Medicaid program; (c) the abuse, neglect, mistreatment of individuals who live in Rhode Island’s skilled nursing facilities and board and care facilities; and (d) to investigate and prosecute cases of abuse, neglect or mistreatment in “noninstitutional” settings where the abuse, neglect or mistreatment involves a Medicaid recipient. The MFCU also works on cases arising under the Rhode Island False Claims Act involving Medicaid Fraud.

Requirements

• College degree with minimum of 5 years of law enforcement or other qualified investigative experience.
• Interviewing and interrogation skills.
• Expertise in evidence collection techniques.
• Experience executing search and arrest warrants.
• Strong writing skills.
• Strong analytical skills.
• Strong organizational skills.
• Strong interpersonal skills.
• Regular, reliable, and punctual in-person attendance at the employee's assigned worksite is an essential function of this position.
• Physical presence is required to ensure effective collaboration, supervision, access to secure or confidential materials, and operational continuity.

Nice To Haves

• Experience investigating health care fraud and compliance.
• Experience investigating other white-collar crimes.
• Knowledge of healthcare accounting principles and practices.
• Knowledge of investigatory databases.
• Knowledge of computer software including Microsoft Excel or Access.
• Knowledge of cost accounting and financial analysis software.

Responsibilities

• Conducting investigations associated with fraud in the administration, billing and provision of services under the RI Medicaid Program.
• Conducting investigations of abuse, neglect and mistreatment of residents in Medicaid funded facilities.
• Working collaboratively in case specific teams with Assistant Attorneys General, analysts, and forensic auditors to conduct complex criminal and civil investigations.
• Working closely with the MFCU’s state and federal partners in multi-jurisdictional and multi-disciplinary task forces on investigations related to the MFCU’s mission.
• Evaluating and analyzing claims data, medical records, and financial records.
• Interviewing victims, witnesses and targets of investigations.
• Conducting surveillance.
• Participating in the execution of search warrants.
• Preparing reports summarizing investigative findings.
• Testifying in court and Grand Jury proceedings.
• Performing other related duties as assigned to meet the organization’s ongoing needs.

Benefits

• For information regarding the benefits available to State of Rhode Island employees, please visit the Office of Employee Benefits' website at http://www.employeebenefits.ri.gov/.
• Direct deposit for all employees is required.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level