What are the responsibilities and job description for the Investigator - Medicaid Fraud Control Unit position at Rhode Island Attorney General's Office?
The Rhode Island Office of the Attorney General is seeking a highly motivated investigator to join the Medicaid Fraud Control and Patient Abuse Unit (MFCU) to investigate complex criminal and civil enforcement actions related to allegations of fraud against the state Medicaid program and allegations of abuse and neglect of residents of long-term care facilities.
About the Office of the Attorney General: The Attorney General is the state’s top lawyer and law enforcement official, protecting and serving the people and interests of Rhode Island through a broad range of duties. Every day, the Office’s attorneys fight to ensure the public safety of the state’s communities, improve the economic security of its citizens, safeguard the state’s spectacular natural resources, and restore the public’s trust in government. Assistant and Special Assistant Attorneys General represent the people of Rhode Island in civil and criminal matters before trial courts, appellate courts, and the supreme courts of Rhode Island and the United States. The Office is unique among attorneys general offices across the country. Out of fifty states, only two other offices share the same broad criminal mission. The Office’s attorneys prosecute complex and violent crimes but also functionally serve as one of the nation’s largest district attorney’s offices, prosecuting all felonies throughout the state.
About the Unit: The mission of the Medicaid Fraud Control Unit (MFCU) for the State of Rhode Island is to investigate and prosecute fraud in the administration of the Medicaid program in Rhode Island, in the provision of medical assistance, or in the activities of providers of medical assistance pursuant to the Medicaid Program. Further, the MFCU seeks to protect residents or patients in health care facilities by investigating and prosecuting allegations of abuse and neglect. The MFCU is responsible for investigating and prosecuting (a) fraud by healthcare providers in the Rhode Island Medicaid program; (b) fraud in the administration of the Rhode Island Medicaid program; (c) the abuse, neglect, mistreatment of individuals who live in Rhode Island’s skilled nursing facilities and board and care facilities; and (d) to investigate and prosecute cases of abuse, neglect or mistreatment in “noninstitutional” settings where the abuse, neglect or mistreatment involves a Medicaid recipient. The MFCU also works on cases arising under the Rhode Island False Claims Act involving Medicaid Fraud.
Primary Duties: The MFCU investigator will be responsible for conducting investigations associated with the fraud in the administration, billing and provision of services under the RI Medicaid Program and investigations of abuse, neglect and mistreatment of residents in Medicaid funded facilities. Investigators work collaboratively in case specific teams with Assistant Attorneys General, analysts, and forensic auditors to conduct complex criminal and civil investigations. The investigator will also work closely with the MFCU’s state and federal partners in multi-jurisdictional and multi-disciplinary task forces on investigations related to the MFCU’s mission. Duties include evaluating and analyzing claims data, medical records, and financial records; interviewing victims, witnesses and targets of investigations; conducting surveillance; participating in the execution of search warrants; preparing reports summarizing investigative findings; testifying in court and Grand Jury proceedings and other related duties.
Position Requirements: College degree with minimum of 5 years of law enforcement or other qualified investigative experience, including interviewing and interrogation skills, expertise in evidence collection techniques, and experience executing search and arrest warrants. Candidates should possess strong writing, analytical, organizational, and interpersonal skills. Preference given to individuals with experience investigating health care fraud and compliance and other white-collar crimes. Knowledge of healthcare accounting principles and practices, investigatory databases, computer software including Microsoft Excel or Access, and cost accounting and financial analysis software is preferred.
If applying for position via mail or email, there is no need to also apply through the online system.
Application Process: Applicants should submit a (1) cover letter summarizing why you are interested and describing the skills and abilities you possess that will enable you to succeed in this position, (2) resume, and (3) a list of three references:
Aida Gomez
Director of Administration
Office of the Attorney General
150 South Main Street Providence, RI 02903
agomez@riag.ri.gov
Equal Opportunity Employer: The Attorney General’s Office is stronger, more credible, and more capable when its employees bring diverse backgrounds, cultures, and perspectives to their work. The Office encourages all qualified applicants from all ethnic and racial backgrounds, veterans, LGBTQ individuals, and persons with disabilities to apply.
All qualified applicants will receive consideration without regard to race, color, sex, religion, sexual orientation, gender identity or expression, age, national origin, disability, or covered veteran status.
Other Information: Finalists will be subject to a full background investigation including reference checks. All offers of employment are contingent upon successful completion of the background investigation.
Regular, reliable, and punctual in-person attendance at the employee's assigned worksite is an essential function of this position. The duties and responsibilities of this role require physical presence to ensure effective collaboration, supervision, access to secure or confidential materials, and operational continuity. While the Office may, in its discretion, permit hybrid telework arrangements in certain circumstances and pursuant to the Office's Telework Policy, such arrangements are granted at the sole discretion of the Office based on operational needs. The grant of hybrid telework does not diminish the in-person attendance requirement as an essential function of the position.