Medicaid Fraud Investigator (60090011)

Not sure you meet all listed requirements? Let our team take a look.

Research shows that women and members of other under-represented groups tend to not apply to jobs when they think they may not meet every qualification. We are committed to creating a diverse and inclusive environment and strongly encourage you to apply.

We encourage applicants with a secondary language skill to apply. 

• THIS IS A NON-SWORN FINANCIAL INVESTIGATOR POSITION *

The Attorney General's office and the Medicaid Investigations Division are committed to ending Health Care Fraud. The link below is provided for your information:

https://ncdoj.gov/responding-to-crime/health-fraud/

The Attorney General's Medicaid Investigations Division investigates and prosecutes health care fraud committed by Medicaid providers and the physical abuse of patients and embezzlement of patient funds in Medicaid-funded facilities. These cases protect and recover taxpayers dollars that can be used to provide needed medical services to Medicaid enrollees.  These cases also protect our most vulnerable elderly and disabled citizens.

This position will perform professional/analytical and law enforcement work in the detection, investigation and punishment of fraudulent and non-fraudulent violation of applicable civil and/or criminal laws (such as those pertaining to fraud in the administration of the Medicaid program, fraud by Medicaid providers, and, as authorized by the office of the Inspector General, the investigation of Medicare and other federal health care fraud cases which are primarily related to Medicaid fraud).  Conduct and participate in wide variety of case investigations involving complex financial analysis.

Position manages investigative assignments and/or projects by:

• analyzing facts and complex documents;
• fieldwork, to include interviewing and coordinating witnesses;
• preparing written investigation reports, serving subpoenas, and preparing witness statements and/or affidavits;
• preparing detailed spreadsheets and charts;
• communicating and consulting with subjects, law enforcement and judicial personnel, Federal and state agencies, and others;
• maintaining confidentiality and discretion in the course of conducting business;
• working individually and/or with others; and adapting to change and circumstances.

Position will lead, participate in, or assist with collection and storage of evidence (to include electronic data and evidence), arrests, execution of search warrants, undercover investigation, and other law enforcement operations pursuant to the case.

The selected candidate is subject to a background investigation.

THE STARTING SALARY FOR A NEW HIRE TO THIS POSITION IS LIMITED TO THE RECRUITMENT RANGE OF $54,197 to $64,358. Salary offers for the selected candidate are based on the candidate's education and experience related to the position, as well as our agency budget and equity.

Note to Current State Employees:

The salary grade for this position is NC16. State employees are encouraged to apply for positions of interest even if the salary grade is the same as, or lower than, their current position.

 Please detail ALL work history including non-state service experience.  If selected for this position, a new salary will be recalculated taking into consideration the quantity of relevant education and experience, funding availability, and internal equity. Based upon these factors, a pay increase MAY or MAY NOT result.

The State of North Carolina offers employer paid health insurance plus twelve paid holidays, generous vacation and sick leave accrual, dental, vision, and other insurance options, and retirement benefits. You can view our benefits information at Employee Benefits. Knowledge of generally accepted accounting principles (GAAP) and financial systems crimes.

Knowledge of federal and state laws, rules and regulations relevant to Medicaid provider fraud and patient abuse investigations during case assignments;

Investigative and examination techniques, processes, and procedures used during investigations;

Locate resources of generally accepted accounting principles, communication and report writing skills,

Conduct Medicaid provider fraud and patient abuse investigations and gather information from relevant sources, conducts field investigations, interview witnesses, report findings, and make decisions based on facts.

Clearly communicate to others general knowledge of accounting principles and financial systems in order to conduct analyses.

Prepare for and conduct interviews in order to facilitate Medicaid provider fraud and patient abuse investigation;

Investigative documentation standards and requirements, and prepare and organize written investigative reports under close supervision.

Maintain professional working relationships with co-workers, supervisors, witnesses and other law enforcement personnel, witnesses, attorneys, court personnel, experts, and others.

Ability to learn to prepare for testimony in judicial proceedings.

Ability to develop consistently sound and accurate conclusions based on general knowledge of accepted financial systems; ability to learn established procedures to identify, gather, organize, understand and analyze financial information and evidence in order to understand financial and business operations of suspects. Some state job postings say you can qualify by an "equivalent combination of education and experience." If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See oshr.nc.gov/experience-guide for details. 

Bachelor's degree in accounting, finance, business administration or criminal justice from an appropriately accredited institution, with 18 credit hours of accounting coursework and two (2) years of experience auditing or investigating white-collar financial crimes;

or equivalent combination of training and experience.

A combination of working knowledge of accounting and financial/tax laws and a background in law enforcement or investigations is preferred. May require certification as a Law Enforcement Officer or Special Agent in accordance with the provisions of the North Carolina Criminal Justice Training and Standards Commission or the ability to achieve certification within one (1) year of employment.The NC Department of Justice accomplishes our goals through our DOJ Organizational Values of Public Service, Integrity, Excellence, Teamwork, Diversity, and Innovation. We encourage all qualified candidates who are committed to these values and want to make a difference in the lives of our citizens to apply for this opportunity.

Please be sure to complete the application in full.

Note the following: If multiple applications are submitted to an individual posting, only the most recent application received prior to the closing date will be accepted. Applications must be submitted by 5:00 PM on the closing date

Resumes and cover letters:   To receive credit for your work history and credentials, you must list the information on the online application form. This information is used to determine if you meet the requirements of the position, and if you are selected, it is used to determine a salary offer.

Using the terms "See Resume" or "See Attachment" will not be accepted and your application will be rejected as incomplete.  Cover letters are highly encouraged but not required.  

Transcripts:  Degrees must be received from appropriately accredited institutions. A copy of your transcripts indicating the degree received can be uploaded with your application.

If a transcript has been requested, your application will be considered incomplete if  you do not provide one. Using a photograph of your diploma is not acceptable.

Credit for foreign degrees will only be given if verification of degree certification is attached to your application.  Transcripts for foreign degrees have to be evaluated by an organization like World Education Services to determine US equivalency.

Any licenses or certificates must be included in the appropriate section of the application form.

Veterans Preference: Applicants seeking Veteran's Preference must attach a copy of their DD-214 or discharge orders.

Applicants seeking National Guard Preference must attach a NGB 23A (RPAS) if you are a current member of the NC National Guard in good standing.  If you are a former member of the NC National Guard who served for at least 6 years and was discharged under honorable conditions, you must attach either a DD256 or NGB 22.

Application status: To check the status of your application, please log in to your account.

Upon the closing date, applications are "Under Review" and will be screened by Human Resources for the qualified applicants. The hiring process may take an average of 6 - 8 weeks.  All applicants will be notified by email once a position is filled.

NeoGov Help Line: If you are having technical issues submitting your application, please call the NeoGov Help Line at 855-524-5627. If there are any questions about this posting, other than your application status, please contact the NC DOJ Human Resources office.

The NC Department of Justice is an Equal Opportunity Employer. The NC Department of Justice uses Merit-Based Recruitment to select from among the most qualified applicants to fill positions subject to the State Human Resources Act.

CONTACT INFORMATION:

NC Department of Justice

Human Resources

114 W. Edenton Street

Raleigh, NC 27603

919-716-6490