Medicaid Fraud Financial Investigations Supervisor (60010503)

US Government, Dept of Justice

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The Financial Investigations Supervisor will perform professional and analytical law enforcement work in

  • the investigation of complex criminal and civil financial frauds and schemes committed by  Medicaid providers, 
  • the investigation of fraud in the administration of the Medicaid Program,
  • the investigation of allegations of the misuse of patient funds at Medicaid-funded facilities, 
  • the investigation of the physical abuse of patients in Medicaid-funded facilities, and
  • as authorized by OIG the investigation of fraud in the Medicare and other federal health care programs related to Medicaid fraud. 
  • The Financial Investigations Supervisor supervises a team of financial investigators who also investigate Medicaid fraud and abuse.

**This requires knowledge of accounting, medical and Medicaid and Medicare terminology and principles, Medicaid and Medicare reimbursement policy and procedure and applicable state and federal criminal, civil, and administrative laws.**

Investigating Criminal Offenses and Civil Cases
Will detect and investigate Medicaid provider fraud and patient abuse and support criminal prosecutors and civil attorneys who bring actions against Medicaid providers who violate applicable criminal and civil laws in state and federal courts.

Detailed analysis of Medicaid claims and reimbursement data, preparation of spreadsheets, review of medical records, field investigation, witness and suspect interviews, search and seizure, custody and control of evidence, working with expert witnesses, preparation of reports, assisting in arrests, and other law enforcement operations.
The support of prosecutors and civil attorneys will include preparing pretrial reports and summaries, evidence preparation, locating and transporting witnesses, testifying as a witness, calculating restitution, and assisting in post-trial sanctioning.

Supervision of Investigators

Will perform professional level work in supervising and managing a team of financial investigators.
Duties will include making investigative assignments, reviewing reports written by financial investigators, analyzing documents and evidence gathered by the financial investigators, monitoring the progress of investigations on at least a monthly basis and more frequently if required, inspecting the investigator’s files and work, ensuring that the financial investigators follow best practices and conduct lawful, appropriate, efficient, and professional investigations, providing support, mentoring, counseling, training, and advice for the financial investigators, acting as a liaison between the financial investigators and the Division Director, Deputy Director, attorneys, and support staff, ensuring that the financial investigators have all needed support, materials, and resources, and maintaining cooperative joint working relationship with federal law enforcement agencies.
The Financial Investigations Supervisor will support the Division Director and Deputy Director in reviewing case referrals and prioritizing the work of the Division.

The North Carolina Department of Justice protects the people of North Carolina through its work to prevent crime and support law enforcement, to safeguard consumers, and to defend the State, its people, and their constitutional rights.

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.

The salary grade for this position is NC19.  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 STARTING SALARY FOR A NEW HIRE TO THIS POSITION IS LIMITED TO THE RECRUITMENT RANGE OF  $62,739 to $105,957. Salary determination is based upon the candidate’s education and experience related to the position, as well as departmental budget and equity considerations. 

Final candidate selection is subject to a criminal records check.

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