Medicaid Fraud Investigator (Investigator 3 - Statewide)

Initial Posting Date:

05/29/2024

Application Deadline:

06/30/2024

Agency:

Department of Justice

Salary Range:

$4,755 - $7,296

Position Type:

Employee

Position Title:

Medicaid Fraud Investigator (Investigator 3 - Statewide)

Job Description:

The Oregon Department of Justice is conducting a nationwide search for experienced investigators interested in joining our team as a Medicaid Fraud Investigator (Investigator 3). We are looking to hire one (1) non-sworn, permanent, full-time position.  Our employees are currently working hybrid work schedules as business needs allow.  The candidate selected for this position will do the same.

Health care fraud enforcement is a national priority. The Medicaid Fraud Unit of our Civil Enforcement Division investigates and prosecutes fraud by Medicaid providers and allegations of abuse/neglect and financial exploitation of residents in long term care facilities.  If selected, you will join DOJ as part of a dynamic, high-achieving, multi-disciplinary team charged with investigating and prosecuting health care fraud state-wide.

WHAT YOU WILL DO (in part)

• Collect, evaluate, and analyze computerized data and other evidence (e.g., medical claims data, financial, records and legal documents).

• Interview witnesses and suspects (including health care professionals, Medicaid agency personnel and Medicaid recipients).

• Draft accurate, detailed reports of investigative findings and interview reports.

• Properly and securely procure physical and documentary evidence.

• Prepare graphs, charts, reports etc. for presentations.

• Process referrals, conduct preliminary screenings, and make recommendations.

• Researching Medicaid policies and programs.

• Testify in grand juries, hearings, and trials.

• Coordinate with other local/state/federal law enforcement entities.

REQUIRED ATTRIBUTES AND SPECIAL REQUIREMENTS 

In order to be considered for this position, you must meet all of the following minimum qualifications.

• Four years of recent (within last ten years) full-time investigative experience which included:  1.) conducting fact finding; 2.) collecting and preserving evidence according to the rules of evidence; 3.) examining records; 4.) locating and interviewing witnesses to verify or disprove claims of suspected law violations; 5.) and writing investigation reports sufficient for use at administrative hearings or in court. Examples of qualifying investigation experience are in areas such as law enforcement investigation, insurance investigation, investigative trial support, or financial fraud investigation. Work experience is based on a 40-hour work week. College-level courses in Law Enforcement, Criminal Justice, Law, Accounting, or Auditing may be substituted on a year-for-year basis for up to one year of the required experience.

• Have and be able to maintain an Oregon State driver license, throughout employment; willing and able to travel as needed (i.e., investigations, court dates, meetings, trainings, etc.).

• Pass a computerized criminal history and driver and motor vehicle services check, as well as clear a comprehensive employment check.  Adverse background data may be grounds for immediate disqualification.

DESIRED SKILLS AND ATTRIBUTES

• Possess excellent analytical, communication, and organizational skills.

• Experience interviewing witnesses and suspects, who are occasionally uncooperative and hostile.

• Experience writing interview and investigative reports

• Experience testifying in administrative, civil, or criminal proceedings.

• Experience working as part of a multidisciplinary team.

• Experience reviewing and analyzing financial records.

• Expert-level in Microsoft Excel, and experience reviewing and analyzing data a plus!

The selection process consists of evaluating applicant’s education, level of experience, training, and overall professionalism within your application work history, resume, and cover letter.  Follow the application directions, provide required documents which clearly showcase your skills.  Do not attach extra documents. Details are important to us, your application materials will be evaluated for presentation, content, clarity, grammar, spelling, and applicable knowledge and skill(s). Those qualified candidates who most closely match the needs of the position and agency will be invited for an initial interview. 

APPLICATION PROCESS