Investigations Analyst

Department Information

Find a rewarding career making a difference: Join the Office of the Attorney General!

The Colorado Medicaid Fraud Control Unit (COMFCU) in the Consumer Protection Section has an opportunity for an Investigations Analyst to partner with the Unit's investigators and attorneys on criminal and civil investigations. COMFCU is a unique unit with the Department of Law, charged with responsibility to investigate and prosecute fraud in healthcare services, as well as protect Colorado's vulnerable populations from abuse and neglect. The unit works across the state with local law enforcement and multiple state agencies, as well as across the country with federal law enforcement, federal agencies, and Medicaid Fraud Control Units in other states.

WHO WE ARE

The Office of the Attorney General/Department of Law is the "People's Lawyer." The Attorney General, Phil Weiser, was elected by the people of Colorado and is the State's chief lawyer and law enforcement official. Our vision for the Department of Law is: "Together, we serve Colorado and its people, advancing the rule of law, protecting our democracy and promoting justice for all." Our core values and commitment to diversity, equity, and inclusion, drive our actions and demonstrate our focus on being principled public servants who are innovative and better together.

Visit our website to learn more: https://coag.gov/.

Description of Job

This position is open only to Colorado state residents.

The Colorado Medicaid Fraud Control Unit (COMFCU) conducts civil and criminal investigations and prosecutes criminal offenses to include fraudulent activity by Medicaid providers (such as hospitals, doctors, pharmacies, nursing homes, etc.) and patient abuse (such as physical assault, sexual assault, homicide and embezzlement of patient trust funds). The unit receives multiple referrals and evaluates them to determine if they warrant further investigation and criminal prosecution in state or federal courts. Often, the unit acts as the lead investigative agency gathering information from partnering law enforcement and regulatory agencies not limited to numerous local, state and federal agencies within the State of Colorado. This unit provides training and technical assistance to law enforcement agencies within the State of Colorado and, as requested, the COMFCU staff will provide advanced training at state or national levels on certain topics.

WHAT YOU WILL DO

The Investigations Analyst will assist the Medicaid Fraud Control Unit with analytical tasks related to Colorado-specific and multistate criminal and civil investigations. This position works in conjunction with criminal investigators, using data obtained during investigations, along with data from the internet, open source checks, the intelligence community, and other law enforcement and regulatory partners at the local, state, and federal level. Investigations analysts are great puzzle solvers and help create the "big picture" that moves an investigation forward. They work independently to assess complex information and determine trends in criminal activity. They leverage knowledge to prepare briefings, reports, and communications for criminal investigators and prosecutors. Tasks performed by an analyst free up criminal investigators to focus on conducting interviews, preparing affidavits, conducting surveillance, and other field work.

This position will work specifically on complex criminal and civil matters including violations of Colorado's Medicaid False Claims Act and the federal False Claims Act. Additionally, this position will work on investigative matters involving felony level theft, forgery, cyber-crime, state tax fraud, and other crimes appropriate for investigation and prosecution by the Medicaid Fraud Control Unit. The Investigations Analyst will:

• Conduct detailed research and analysis of investigative information relating to alleged violations of health care fraud, fraudulent administration of the Medicaid program, and/or the alleged abuse or neglect of patients in health care facilities governed by the State Medicaid program;

• Collect and analyze multiple sources of data obtained during investigations;

• Perform detailed analysis of bank records, reimbursement records, and other financial records to create an accurate picture of a target's business operations and personal spending;

• Proactively assess complex information, spotting trends, and making real-time analytical judgments;

• Prepare briefings, reports, and communications for criminal investigators and prosecutors;

• Collect and analyze medical data including medical coding data;

• Create documentation to assist with case organization and investigative support including intelligence reports, documentation of the processes used to obtain information, documentation of data analysis, and the review of financial, and other records;

• Organize data in maps, charts, graphs, spreadsheets, databases, PowerPoint presentations, and other images to illustrate correlations and patterns of criminal activity;

• At times, testify before a jury or grand jury regarding analyses, summaries, and conclusions.

Salary note: Although a salary range is listed, salary will be set commensurate with the successful candidate's qualifications and in compliance with the Equal Pay for Equal Work Act. Salary will be paid on a biweekly basis.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

WHAT WE ARE LOOKING FOR

Minimum Qualifications: Please document all relevant experience in detail on your application. Experience will not be inferred or assumed. Any part-time experience listed will be prorated.

• Six years of professional experience performing data analysis using multiple sources of data. Data analysis experience must include collection, analysis, interpretation, and providing summaries of data.

OR

• A Bachelor's degree from an accredited institution in computer science, data analytics, criminal justice, forensic science, sociology, psychology, accounting, health care related fields, or a field of study related to the assignment AND two (2) years of professional experience performing data analysis using multiple sources of data. Data analysis experience must include collection, analysis, interpretation, and providing summaries of data.

OR

• A Master's degree from an accredited institution in business administration, computer science, data analytics, criminal justice, forensic science, health care related fields, or other directly related field of study AND one (1) year of professional experience performing data analysis using multiple sources of data. Data analysis experience must include collection, analysis, interpretation, and providing summaries of data.

Note: Candidates possessing a foreign degree must submit a translation (evaluation) of their degree from an accredited institution, such as The National Association of Credential Evaluations Services in order to be given credit for the degree.

Required Competencies:

• Strong technical aptitude including proficiency with MS Office applications including Outlook, Word, and Excel and ability to research and learn multiple databases;

• Strong critical thinking and problem solving skills;

• Ability to work with a wide variety of stakeholders on data analysis projects;

• Ability to manage tasks while working on multiple cases at the same time.

Preferred Qualifications: In addition to the minimum qualifications, if you possess any of the following specifically include the details on your application, as this information will be used to assess your qualifications and may be used to determine a top group of applicants.

• Experience using Criminal Justice databases;

• Experience using geospatial systems;

• Experience providing analytical support to a team;

• Experience working with law enforcement criminal investigations units;

• Experience analyzing cell phone and social media data in complex investigations;

• Experience with health care compliance and/or auditing medical billing and coding;

• Experience with financial auditing;

• Outstanding attention to detail;

• Experience presenting findings in visual formats such as maps, charts, graphs, PowerPoint presentations, and other images to illustrate correlations and patterns.

Conditions of Employment:

• Applicants must pass a thorough background investigation prior to appointment.

• Both in-person and remote work will be required.

HOW TO APPLY

Required Application Materials:

• A completed State of Colorado Application: Applicants are responsible for ensuring that the application provided is fully completed and clearly describes their education, training and experience as it relates to this position. Applications left blank or marked "See Resume" will not be considered.

• Resume: A detailed resume outlining your background skills and experiences including previously held positions and academic background. Any information regarding your skills, qualifications, accomplishments, etc. and how you meet any of the listed preferred qualifications is highly encouraged. Your resume will be reviewed as part of the comparative analysis process.

• Cover Letter: A brief cover letter detailing your interest in the position, relevant experience and any additional information you'd like to share as it relates to your interest in the position.

Veteran's Preference: In order to be considered for veteran's preference you must attach a copy of your DD214 forms as well as any documentation required to prove disability or marital status.

Your application will be reviewed by a qualified Human Resources Specialist to determine if you meet the minimum qualifications for this position. If your application does not demonstrate that you meet the minimum requirements, you will be notified that you will not proceed in the selection process for this position. If your application is rejected and you have questions, you may contact Susie Esparza at susie.esparza@coag.gov.

Assessment Information:

Colorado Revised Statutes require that all state employees be hired and promoted through comparative analysis of merit and fitness. Upon meeting the minimum qualifications, the next phase of the process is typically a structured application/resume review by a panel of subject matter experts against the job duties and/or preferred qualifications in this job announcement to determine technical competence, depth and breadth of experience and potential job fit.

• Technical Competence

• Technical experience as it relates to the duties outlined in this job announcement.

• Depth and Breadth of Experience

• Experience that covers multiple areas outlined in this job announcement and demonstrates the level of responsibility assigned.

• Job Fit

• Experience will be evaluated to determine how well experience aligns with and meets the business needs of this position. Current experience is preferred.

It is imperative that the "Work Experience" section of your application is complete and specifically addresses your qualifications, experience, work product, and accomplishments as they relate to the Description of the Job, Minimum Qualifications, and Preferred Qualifications as listed above. Failure to include adequate information or follow instructions by the closing date may result in your application not being accepted and/or may affect your inclusion in the final pool of eligible applicants as the materials may be used to identify a top group for additional assessment or establish an eligible list for referral to the hiring manager for final consideration.

Appeal Rights:

If you receive notice that you have been eliminated from consideration for this position, you may file an appeal with the State Personnel Board or request a review by the State Personnel Director.

An appeal or review must be submitted on the official appeal form, signed by you or your representative. This form must be delivered to the State Personnel Board by email, US Mail, faxed or hand delivered within ten (10) calendar days from your receipt of notice or acknowledgement of the department's action.

For more information about the appeals process, the official appeal form, and how to deliver it to the State Personnel Board go to spb.colorado.gov or refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov under Rules.

Supplemental Information

WHY WORK FOR US

We Embrace Flexibility

We aim to produce outstanding work product for our clients, be efficient with our time, and support each other as team members - which also means we embrace flexible working arrangements when and where possible.

We Are Committed to Diversity, Equity and Inclusion

At the DOL, our commitment to DEI is thriving. We know that we are better together when our differences are valued and everyone is inspired and empowered to contribute. As such, we strive to provide a safe environment where individuals feel valued and respected for who they are; demonstrate a behavior and mindset where differences are welcomed, and individuals are treated equally and empowered to do their best work; and promote growth and innovation through a diverse workforce. We empower an active Diversity Equity & Inclusion Impact Team that creates approaches to ensure safe spaces and a culture supportive of people being their authentic selves, hosts events and programs on DEI areas important to our employees, enables development and sustainability of resource groups that give a voice to historically marginalized populations, focuses on retaining our incredible talent, and more! If your professional goals include promoting growth and innovation with colleagues who recognize that we are better together when our differences are valued and respected, then DOL is your place to be!

We Have Strong Core Values

Our core values drive our actions. At the Department of Law, we are: 1) principled, maintaining the highest ethical standards, rigorous legal analysis, and careful evaluation of facts; 2) public servants, who are always ensuring our work is not about us, but instead is about the people of Colorado; 3) innovative, by seeking to identify the best approach, make deliberate decisions, and look to improve; and 4) "better together," by working to support each other and collaborate.

We are Committed to Developing our Employees

We are deeply invested in our talent and regularly provide meaningful opportunities for personal and professional growth through training and coaching. Further, our professional development and performance goal setting process is collaborative and ongoing, and aimed at helping our employees grow and succeed.

We Offer Excellent Benefits

In addition to the comprehensive State of Colorado benefits package including competitive medical and dental health plans, employer-paid life insurance, paid holidays, retirement plans with Colorado PERA, and vacation and sick leave earned each month, there are many other unique benefits that we offer, including:

• Medical and dental health plans

• Employer-paid life insurance

• Paid vacation and sick leave earned each month

• 11 paid holidays per year

• Public Service Loan Forgiveness

• The Public Service Loan Forgiveness Program forgives the remaining balance on your direct loans after you have made 120 qualifying monthly payments under a repayment plan while working full-time for a qualified employer.

• Free access to an on-site fitness center

• Strong, flexible retirement benefits including 401K and 457 plans

• Distinctive career advancement opportunities throughout the State personnel system

• Excellent work-life programs, such as flexible work schedules, professional development opportunities, and an employee discount program

The State of Colorado believes that equity, diversity, and inclusion drive our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them. Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.

The Department of Law is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship. If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, Julie Christopher, at hr@coag.gov.