Wake County, NC Full Time
Job Posting for Analyst, CJ Specialist/Investigator II, Medicaid Investigations at State of North Carolina
THE STARTING SALARY FOR A NEW HIRE TO THIS POSITION IS LIMITED TO THE RECRUITMENT RANGE OF $ 33,960 to $ 46,713. 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.
The North Carolina Department of Justice, led by the Attorney General of North Carolina, represents the State of North Carolina in court and provides legal advice and representation to most state government departments, agencies, officers, and commissions. The Department also represents the State in criminal appeals from state trial courts, and brings legal actions on behalf of the state and its citizens when the public interest is at stake.
This position is located in the Medicaid Investigations Division of the Department of Justice. 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.
Our Medicaid Investigations Division (MID) is staffed by Department of Justice attorneys, investigators, auditors, analysts, and a nurse investigator, paralegals, and administrative staff. MID provides state and national training opportunities to aid employees in understanding the complexities of health care fraud investigations. This position has the opportunity to work cases in state and federal court in partnership with law enforcement agents with federal and state agencies such the Office of Inspector General, FBI, IRS, NC State Bureau of Investigations, Sheriff’s Offices, and Police Departments.
Over the past decade, the NC MID has recovered more than $500 million and helped win more than 450 criminal convictions in health care fraud and abuse cases.
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://www.ncdoj.gov/Top-Issues/Stop-Health-Fraud-(1).aspx
The primary purpose of this analyst position is to provide criminal intelligence and data analysis, data organization and data presentation assistance to Medicaid Fraud Financial Investigators pertaining to investigations of Medicaid fraud and abuse. The employee assists Medicaid Fraud Financial Investigators and one or more teams of attorneys and investigators in the detection, investigation, and punishment of fraudulent and non-fraudulent violations of applicable criminal and civil laws pertaining to fraud and abuse by Medicaid providers and in administration of the Medicaid Program.
This analyst will also support the investigation of Medicare and other federal health care fraud cases and investigations which are primarily related to Medicaid fraud involving complex financial analysis. This individual will
- prepare detailed spreadsheets and charts, review medical records, prepare written investigative reports, research public records, analyze facts and documents, and assist in the collection and storage of evidence.
- receive, document, research, gather information, and prepare reports of referrals from citizens, providers, recipients, and other professionals within and outside of the Medicaid agency who report Medicaid fraud abuse.
- must be able to suggest leads to investigators and assist in preparation of investigative requests for records, subpoenas and search warrants.
- must also perform administrative duties to include preparation of management reports and other duties as needed.
- This investigator typically works in the office, but may occasionally be required to work in the field to obtain pertinent information.
The successful candidate must undergo and successfully complete a comprehensive background check as part of the hiring process.
This position is subject to the Fair Labor Standards Act. This position will require travel and overnight travel.
Note to Current State Employees:
The salary grade for this position is GN08. 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 ten 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.
Considerable knowledge of criminal justice and law enforcement procedure, terminology, and personnel policies and practices.
Ability to interpret, apply, and communicate statutory regulations of the assigned area.
Ability to analyze, interpret, recommend, and implement policy and procedural guidelines. Ability to instruct and explain standards and procedures.
Ability to establish effective working relationships, including seeking compliance with regulations.
Ability to express oneself clearly and concisely, tactfully and professionally in oral and written form,
Ability to work independently and use sound judgment in making decisions.
Strong skills in utilizing word processing, spreadsheet, and database software, email functions, and Internet Web browser skills. The employee must have knowledge of modern office procedures, practices, and equipment including Word, Excel, Access, email, Internet browsers, relational databases, and an effective working knowledge of Medicaid coverage policy and claims processing and data systems.
Strong organizational skills and file management skills.
Strong problem solving skills; the ability to make inferences and deductions from a vast array of intelligence sources pertaining to criminal activities and organizations.
Must have the ability to learn and adapt to ever-changing computer software; the ability to provide written and oral briefings, reports and training to law enforcement agencies on trends and patterns of criminal activity and new and existing analytical techniques in criminal intelligence; the ability to exercise judgment and discretion in establishing, applying and interpreting policies, procedures, and administrative rules; and the ability to establish and maintain effective working relationships with multi-agency personnel and administrators.
Must comply with rules and regulations regarding confidentiality and the dissemination of information using proper judgment with regard to sensitive and critical information and maintain confidentiality as required by applicable laws and regulations.
The employee must have a thorough knowledge of the intelligence process and methodology.
Bachelor s degree from an appropriately accredited institution and two years of administrative and/or technical experience in criminal justice or law enforcement as it relates to the area of assignment, or an equivalent combination of education and experience.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.
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 Office
Lisa Sasser, Recruitment Specialist
114 W. Edenton Street
Raleigh, NC 27603
919-716-6490
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