Investigator - Medicaid Fraud Control Unit
About The Position
The Office of Attorney General's Medicaid Fraud Control Unit (MFCU) has an opening for an Investigator. The MFCU is an interdisciplinary team dedicated to protecting vulnerable individuals and safeguarding Medicaid's finite resources. The MFCU utilizes a team-based approach to uncover abuse and neglect of Medicaid recipients and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, physicians, dentists, nurses, and other Medicaid providers. The MFCU holds offenders accountable through criminal prosecution and civil litigation. Investigations often involve multi-agency coordination, detailed document analysis, and preparation for prosecution.
Requirements
- Good analytical and research skills
- A bachelor's degree or equivalent experience
- Ability to write clearly and informatively
- Ability to read and interpret written information
- Ability to maintain confidentiality, strategically plan, prioritize, organize effectively, communicate effectively in writing and orally, and exercise independent judgment
- Ability to work independently or as part of a team
- Teamwork skills are essential to success
Nice To Haves
- Experience using Word and Excel
- Experience in investigations or audits of health care providers
- Forensic accounting experience
- White-collar crime investigations experience
Responsibilities
- Conducting interviews
- Obtaining and analyzing Medicaid claims
- Reviewing healthcare provider documentation
- Preparing detailed investigative reports and exhibits
- Maintaining investigative case files
- Testifying in court
- Interfacing with other law enforcement and government agencies
- Collecting and analyzing evidence
- Preparing reports and exhibits to include testimony in courts
- Collecting evidence for possible use in civil or criminal proceedings
- Review and evaluate allegations of fraud, or abuse/neglect of Medicaid recipients
- Assist attorneys in case preparation
- Testify at grand jury and trial as needed
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
