Senior CHCF Investigator
Harrisburg, PA
Full Time
Mid Level
Senior Civil Health Care Fraud Investigator
ROLE
We need an experienced Senior Civil Health Care Fraud Investigator at USAO MDPA. The United States Attorney's Office for the Middle District of Pennsylvania regularly investigates and litigates matters involving fraud committed on public health care benefits programs including Medicare, Medicaid, TRICARE, and the Federal Employees Health Benefits Program. In this role, you will support the planning and conduction of investigations, assist AUSAs in determining violations of Federal statutes, examine and analyze financial and documentary evidence, trace funds derived from fraud, and assist with preparation for litigation and trial including the creation of exhibits and audio-visual materials. This is a full-time opportunity. We can offer a competitive salary, and a comprehensive benefits package.
Apply today!
RESPONSIBILITIES
REQUIRED EXPERIENCE
PREFERRED EXPERIENCE
EDUCATION
LOCATION
CLEARANCE
CLIENT
HOURS
EMPLOYMENT CLASSIFICATION
RELOCATION
COMPENSATION
West 4th Strategy is an Equal Opportunity (EEO) employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, gender, sexual orientation, ancestry, national origin, age, marital status, mental disability, physical disability, medical condition, pregnancy, political affiliation, military or veteran status, or any other basis prohibited by federal or state law.
Other Considerations: This position is W-2 only; no Corp-to-Corp or 1099 candidates. Relocation will not be offered. This position requires access to Department of Justice facilities and systems. As a condition of employment, selected candidates must complete and receive favorable adjudication from a federal government background investigation as required by the U.S. Department of Justice. Individual’s primary workstation is located in an office area. The noise level in this environment is low to moderate. Regularly required to sit for extended periods up to 80% of the time; frequently required to move about to access file cabinets and use office equipment such as PC, copier, fax, telephone, cell phone, etc. Occasionally required to reach overhead, bend, and lift objects of up to 10 lbs. Specific vision abilities required by this job include the use of computer monitor screens up to 80% of the time.
ROLE
We need an experienced Senior Civil Health Care Fraud Investigator at USAO MDPA. The United States Attorney's Office for the Middle District of Pennsylvania regularly investigates and litigates matters involving fraud committed on public health care benefits programs including Medicare, Medicaid, TRICARE, and the Federal Employees Health Benefits Program. In this role, you will support the planning and conduction of investigations, assist AUSAs in determining violations of Federal statutes, examine and analyze financial and documentary evidence, trace funds derived from fraud, and assist with preparation for litigation and trial including the creation of exhibits and audio-visual materials. This is a full-time opportunity. We can offer a competitive salary, and a comprehensive benefits package.
Apply today!
RESPONSIBILITIES
- Supports the planning and conduction of investigations in conjunction with federal agents to determine whether there have been violations of Federal statutes, e.g., False Claims Act, Stark Law, and Anti-Kickback Act.
- Works with AUSAs to identify possible violations or causes of action, determine proof required to affix legal responsibility, and devise methods for obtaining, preserving, and presenting evidence.
- Determines the most effective methods for planning, scheduling, and conducting investigations, including interviews, subpoenas, and depositions. Secures participation of appropriate law enforcement agents.
- Contacts federal, state, and local officials and business representatives to gather information, documents, and statements on current or potential investigations.
- Assists AUSAs with identifying, locating, and interviewing witnesses. Conducts surveillance of suspects. Communicates with counsel of subjects and witnesses.
- Examines, analyzes, and secures evidence including documents, financial statements, billing records, emails, correspondence, and computer data pertaining to the allegations under investigation.
- Reviews laws, rules, regulations, and policies to determine whether health care billings were improper. Traces funds derived from fraud and identifies assets of subjects.
- Confirms authenticity of documents, corroborates witness statements, and arranges for the secure storage, preservation, and indexing of physical and electronic evidence.
- Prepares interim and final reports on investigation progress for AUSAs and supervisory attorneys, including findings, recommendations for additional investigative actions, and candid assessments of evidence and witnesses.
- Assists AUSAs with preparation for litigation and trial, including compiling evidence and creating charts, graphs, and other audio-visual materials for use in motions and at trial.
- Other related duties as assigned and within scope
REQUIRED EXPERIENCE
- Minimum ten (10) years of experience in any combination of law enforcement, criminal justice experience, and health care fraud investigation.
- Experience testifying in court matters
- Proficient in Microsoft Office software programs (i.e., Word, Excel, Outlook, etc.)
- Experience and expertise in performing the responsibilities above
PREFERRED EXPERIENCE
- CPA Certification
- Experience working with a federal or state law enforcement entity
EDUCATION
- Bachelor's degree in law enforcement, criminal justice, accounting, finance or related field.
LOCATION
- U.S. Attorney's Office, Harrisburg, Pennsylvania 17102
CLEARANCE
- Must be able to pass a Department of Justice background investigation
- Must be a US Citizen
CLIENT
- U.S. Attorney’s Office for the Middle District of Pennsylvania
HOURS
- 40 hours per week
- 8 hours per day
EMPLOYMENT CLASSIFICATION
- Employment Classification Eligibility – W2
RELOCATION
- Not eligible for relocation benefits
COMPENSATION
- Salary Range: $80,000 - $105,000
- Benefits: Benefits package includes options for health, dental and vision insurance coverage
West 4th Strategy is an Equal Opportunity (EEO) employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, gender, sexual orientation, ancestry, national origin, age, marital status, mental disability, physical disability, medical condition, pregnancy, political affiliation, military or veteran status, or any other basis prohibited by federal or state law.
Other Considerations: This position is W-2 only; no Corp-to-Corp or 1099 candidates. Relocation will not be offered. This position requires access to Department of Justice facilities and systems. As a condition of employment, selected candidates must complete and receive favorable adjudication from a federal government background investigation as required by the U.S. Department of Justice. Individual’s primary workstation is located in an office area. The noise level in this environment is low to moderate. Regularly required to sit for extended periods up to 80% of the time; frequently required to move about to access file cabinets and use office equipment such as PC, copier, fax, telephone, cell phone, etc. Occasionally required to reach overhead, bend, and lift objects of up to 10 lbs. Specific vision abilities required by this job include the use of computer monitor screens up to 80% of the time.
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