Medicaid Fraud Investigator (Special Agent III)
Details
- Section:
- Consumer Protection
- Position Number:
- LAA-00027
- Salary Range:
- $96,396.00 - $116,400.00 Yearly
- Apply By:
- Monday, September 16, 2024, 11:59 pm
- FLSA:
- 7K
- Work Unit:
- Medicaid Fraud Control Unit
- Job Location:
- 1300 Broadway, Denver, CO 80203
- Release Date:
- Thursday, August 22, 2024
- Employment Type:
- Full-Time
- Position Type:
- Classified
The Consumer Protection Section is seeking an experienced investigator to join the Colorado Medicaid Fraud Control Unit (“COMFCU”). The COMFCU is crucial to preventing and holding providers accountable for Medicaid fraud and patient abuse across the state of Colorado. This position is ideal for someone who not only takes pride in the skills and abilities that they have developed thus far in their career, but seeks to expand that skillset while working in a fast-paced environment and making a difference for Colorado’s most vulnerable populations.
This position is open only to Colorado state residents.
WHAT YOU WILL DO
The COMFCU maintains a strong commitment to ensuring that Coloradans have access to the highest quality of care from dedicated providers while continuing to take an aggressive approach to preventing and prosecuting Medicaid fraud and patient abuse across the state.
The dual missions of the COMFCU are:
- To protect the state and federal funds dedicated to providing health care and medical services to Colorado Medicaid beneficiaries.
- To hold individuals accountable for the abuse, neglect, or financial exploitation of clients in board and care facilities as well as those in facilities that accept Medicaid dollars.
This unit receives multiple referrals and evaluates them to determine if they warrant further investigation and criminal prosecution in state court. 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.
The Investigator position is a critical team member of the COMFCU that will work both independently and as part of a multidisciplinary team to conduct civil and criminal investigations, litigation, and prosecution of fraudulent activity by Medicaid providers (such as hospitals, doctors, pharmacies, nursing homes, etc.) and of patient abuse (such as physical assault, sexual assault, homicide and embezzlement of patient trust funds). This position may also be assigned to civil investigations in support of the Colorado False Claims Act. Additionally, the incumbent will provide technical training, advice and assistance to other law enforcement agencies in various jurisdictions across Colorado in the investigation of such matters.
This recruitment may also be used to fill other Special Agent positions in the Consumer Protection section.
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 investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency.
OR
- A combination of directly related education (such as Criminal Justice, Psychology, or Sociology) and professional investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency equal to six (6) years.
Required Competencies: The following knowledge, skills, and abilities are required for this position and will be considered during the selection process, including examination and/ or interview:
- Demonstrated organizational skills, including the ability to multi-task, prioritize tasks, and meet deadlines;
- Demonstrated work experience managing or leading large-scale or complex investigations;
- Strong oral and written communication skills, including the ability to communicate concisely and effectively;
- Customer service and interpersonal skills, including the ability to work on a team;
- Strong critical thinking and analytical skills.
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 investigating and researching matters involving violations of State and Federal regulations;
- Work experience with Medicaid or Medicare regulations and statutes;
- Experience investigating document intensive white collar fraud cases from intake to completion;
- Experience working with medical records and bank records during the course of an investigation;
- Work experience with database programs, such as Excel or Access, used to analyze data and track evidence;
- Proficiency in Spanish, Chinese, German, Vietnamese, or another commonly spoken language in Colorado;
- Training as a forensic interviewer;
- Experience in planning tactical operations;
- Experience working with multidisciplinary investigation and prosecution teams, including with state or federal agency partners;
- Experience conducting public outreach;
- Certified Fraud Examiner;
- Experience/training as a FTO or as a LE instructor;
- Participation with health care fraud or elder abuse task forces or committees;
- Experience investigating cases involving vulnerable populations, including working cases involving victims/witnesses with developmental or intellectual disabilities.
- Experience working in a fast-paced environment that involves managing an active caseload.
Conditions of Employment:
- Candidates must be Colorado P.O.S.T. certified at the time of application. In accordance with C.R.S. §24-31-303 (5)(a) and (b), applicants must be Colorado P.O.S.T. certified, including the requirement of completing a physical and psychological evaluation (if it has been more than three years since a physical and psychological evaluation has been conducted). Following a conditional job offer, but prior to appointment, a candidate not meeting the requirement of C.R.S. §24-31-303(5)(b) will be subject to a physical and psychological evaluation to determine fitness to serve as a peace officer. Must be proficient with a handgun. Must be available, sometimes on short notice, to travel within and outside the State of Colorado. Must be available to work nights and/or weekends when necessary to conduct fast-paced investigations, execute search warrants, or prepare for trial.
- Applicants must pass a thorough criminal and personal background check, including a review of the personnel file from prior employment.
- Position may be required to work outside of regular business hours, including possible early mornings, evenings, weekend, and overnight assignments. This is not an on-call position. Position must have a valid CO driver’s license.
- This position may be eligible for flexible work arrangements, including a hybrid work schedule after an initial training period.
Please view the full job description for more information, including information about compensation and benefits, and to apply online.