Medicaid Fraud Special Investigator, Sworn
North Carolina Office of State Personnel - Wake County, NC

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This position is available to current NC Department of Justice employees only.

The Medicaid Fraud Special Investigator is a sworn law enforcement official and will perform professional/analytical and law enforcement work in the detection, investigation, and punishment of fraudulent and non-fraudulent violations 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 Inspector General, the investigation of Medicare and other federal health care fraud cases which are primarily related to Medicaid fraud). Position will conduct and participate in a wide variety of case investigations involving financial analysis. Work requires knowledge of applicable state and federal laws and regulations. Position manages investigative assignments and/or projects; will prepare written investigation reports, make arrests, serve subpoenas and search warrants, and will prepare witness statements and/or affidavits; research public records; analyze facts and complex documents; interview and coordinate witnesses; communicate and consult with subjects, law enforcement and judicial personnel, federal and state agencies, and others; testify in judicial proceedings; maintain confidentiality and discretion in the course of conducting business; work individually and/or with others; and adapt to change and circumstances. Position will lead, participate in, or assist with collection and storage of evidence, arrests, execution of search warrants, undercover investigation, and other law enforcement operations pursuant to the case.
The Medicaid Fraud Special Investigator must also perform administrative duties to include weekly reports, monthly expense reports, and submit leave slips when requesting annual, sick, or compensatory leave. Position must collaborate with and provide assistance to the Deputy Director of the Unit as requested in order to create the annual Medicaid Fraud Control Unit budget, quarterly reports, and other financial reports for state and federal funding of the Unit, and the Unit's Annual Report in order to comply with federal and state grant and regulations.
The Medicaid Fraud Special Investigator must also perform duties assigned by the Special Agent in Charge to include representing the Department of Justice at public and private functions to educate and provide information relative to Medicaid fraud investigations and initiatives undertaken by the Department.
DOJ has a competency based recruitment program; recruitment for this position is at the Advanced level, equivalent to pay grade 77. If advanced candidates are not available, management reserves the right to select journey level candidate. Selected candidate will undergo and must successfuly complete a comprehensive background investigation.

Knowledge, Skills and Abilities / Competencies:

PROFESSIONAL KNOWLEDGE: Able to conduct complex Medicaid provider fraud and patient abuse investigations; advanced knowledge of generally accepted accngt. principles & financial systems; advanced knowledge of medicaid reimbursement policy & procedures; knowledge of state & federal criminal, civil & administrative laws and judicial procedures.
COMMUNICATION: clearly communicates verbal & written information; prepare for/conduct interviews/examinations; testify as primary subject matter & expert witness and assist others in preparing & testifying. Maintain confidentiality.
INVESTIGATION, ANALYSIS & DECISION MAKING: develops & executes investiative plan in completx investigations; prepare & organize investigative reports, subpoenas search and arrest warrants.

Minimum Education and Experience Requirements:

Bachelor's degree preferably in accounting, finance, business administration, or criminal justice with eighteen credit hours of accounting coursework or a bachelor's degree preferably in accounting, finance business administration, or criminal justice and two 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 laws and a background in law enforcement or investigations is preferred. All degrees must be received from appropriately accredited institutions.

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 year of employment.

Management preferences: 18 credit hours of accounting course work.

Supplemental and Contact Information:

Computer literacy is an important component of all DOJ jobs, we encourage you to apply electronically. All applicants must complete and submit a State application for employment using the new NEOGOV Online Job Application System ( ) for the State of North Carolina. To receive credit for your work history and credentials, you must list the information on the online application form. Any information not included on the application form cannot be considered for qualifying credit. Any licenses or certificates must be included in the appropriate section of the application form. Attached or incorporated resumes will be accepted, but will not be used for qualifying credit. Other attachments will also be accepted, but not used in screening for qualifying credit. Applicants are required to attach a copy of their DD-214 or discharge orders if they wish to obtain veterans preference.
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 Personnel Act. Applicants are asked to document competencies related to the position for which you apply on the State application. A competency is defined as a set of behaviors or duties that reflect skills, knowledge and abilities.
Once the position has been filled, all on-line applicants will be notified via the e-mail provided at the time of application.
NC Department of Justice
Human Resources Management Office
Lisa Sasser, Recruitment Specialist
114 W. Edenton Street
Raleigh, NC 27603

North Carolina Office of State Human Resources - 17 months ago - save job