Healthcare Fraud Investigator

Job Summary Based on cases or broad legal issues assigned to one or more Assistant United States Attorneys (AUSAs) and at the AUSA's direction, the investigator independently plans and conducts investigations of civil or administrative matters specializing in Healthcare Fraud. Cases may concern sensitive matters, involve prominent individuals, organizations or corporations within a U.S. Attorney's district; involve issues cutting across jurisdictional lines; and often are characterized by obscure leads, few visible records, uncooperative witnesses, and/or conflicting evidence. Investigations may be conducted solely by the USAO, or more typically, in conjunction with other federal and/or state or local agencies responsible for programs supported by federal funding. These federal agencies include, but are not limited to, the Federal Bureau of Investigation (FBI), the Department of Health and Human Services (HHS), the Office of Personnel Management (OPM), the U.S. Postal Inspection Service (USPIS), the Department of Labor (DOL), and/or the Security and Exchange Commission (SEC). Duties Working with the assigned AUSAs and/or supervisory attorneys determines applicable administrative statutory and regulatory law and identifies possible violations or causes of action. Develops an understanding of all applicable federal, state, or local laws to the extent necessary to make sound decisions on direction and scope of investigations. Determines proof required to assist in affixing legal responsibility for litigation, and devises methods for obtaining, preserving, and presenting evidence to greatest effect. Decides upon most efficacious methods for planning, scheduling, and conducting investigations, and identifies any resources that may be required. Refers evidence of criminal activities to appropriate criminal investigators or sworn law enforcement officers. Initiates contacts with federal, state, and local officials, and other organizations and individuals related to the subject of investigation, for the purpose of gathering facts, obtaining statements, learning sequences of events, obtaining explanations and otherwise advancing investigative objectives. Examines books, ledgers, payrolls, cost reports, billing statements, invoices, correspondence, computer data, and other records pertaining to the transactions, events, or allegations under investigation. Establishes and/or verifies relationships among all facts and evidence obtained or presented to confirm authenticity of documents, corroborate witness statements, and otherwise build proof necessary for successful litigation. Utilizes laboratories and other forensic services to identify handwriting, fingerprints, questioned documents and substances, sound and video recordings, and other physical evidence. Arranges for secure storage, preservation, organization, and indexing of voluminous documentary evidence. Conducts in-person and/or telephonic interviews of witnesses. Identifies the need for service of warrants and subpoenas and secures participation of appropriate law enforcement agents in executions of same. Types hand scribed notes from interview discussions. Coordinates surveillance of suspects with appropriate law enforcement/investigative agencies. Occasional surveillance activities personally performed occur in locations that are open and accessible to the public where there is little or no risk of physical harm to the contractor or others. The contractor does not have arrest authority nor is authorized the use of deadly force. "Undercover" work characteristically does not involve physical interaction with the subject or target of a criminal investigation. Prepares interim and final reports on progress of investigations for use by AUSAs and supervisory attorneys. Includes significant findings and conclusions, recommendations for additional investigative actions, and candid assessments of strengths and weaknesses of witnesses, documentary evidence, or other aspects of case. Assists in compilation of documents and physical evidence, and creation of charts, graphs, videotapes, and other audio-visual materials for use by AUSAs in motions and at trial. Provides advice to AUSA on selection of witnesses and ensures their attendance through subpoena or otherwise. Testifies in court regarding investigations, as required. Performs other related duties as assigned. Qualifications Proven experience or background in law enforcement, security, or related investigative fields is highly desirable. Strong report writing skills with the ability to clearly document complex cases and findings. Proficiency in data collection methods and analysis tools used for fraud detection. Experience with surveillance techniques and security protocols to monitor suspicious activities effectively. Ability to conduct research on healthcare policies, billing practices, and legal regulations relevant to fraud investigations. Knowledge of healthcare systems, claims processing, and common types of healthcare fraud is a plus. Excellent communication skills for interviewing witnesses, collaborating with teams, and preparing comprehensive reports. This position is essential for maintaining the integrity of healthcare services while offering a rewarding career dedicated to justice and security in the health sector. Bachelor's degree or higher U.S.

Citizenship Pay:

$40.00 - $45.00 per hour

Benefits:

Paid time off

Work Location:

In person