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Civil Healthcare Fraud Investigator

2 months ago

Detroit, Michigan, United States Ardelle Associates Full time
About the Role

Ardelle Associates, a leading provider of consulting and support services to government agencies, is seeking a highly skilled and detail-oriented Fraud Investigator to support the Department of Justice (DOJ), U.S. Attorney's Office (USAO) in Detroit, MI.

Key Responsibilities
  • Develop a deep understanding of applicable federal, state, and local statutes, regulations, and guidance to inform sound decisions on investigation direction and scope.
  • Analyze publicly available materials, governmental databases, and other sources to identify potential violations of federal law, and conduct preliminary investigations to confirm such violations.
  • Assist in the investigation of affirmative cases handled by Assistant United States Attorneys, including:
    • Identifying witnesses and developing investigative plans.
    • Creating and implementing strategies, and providing direction to investigators from client agencies.
    • Drafting and monitoring subpoenas and other document requests and demands.
    • Reviewing and analyzing documents, conducting interviews, and producing well-written interview reports, spreadsheets, status reports, recommendations, assessments, and other analyses.
    • Utilizing forensic services to obtain and analyze evidence, coordinating and participating in surveillance, securing, organizing, and preserving evidence, and building and presenting proof necessary for successful affirmative cases.
  • Obtain and analyze financial records and information regarding assets and ability to pay of subjects under investigation, utilizing electronic databases, publicly available sources, interviews, and other investigative tools.
  • Identify and develop human sources that may provide information regarding violations of federal law, and assist in the investigations of such violations.
  • Build and maintain excellent relationships with state, local, and federal law enforcement agencies in Michigan and neighboring jurisdictions involved in the investigation of violations of federal laws or fraud on federal programs, including participation in task forces.
Requirements
  • Bachelor's Degree or higher in law enforcement/criminal justice (or another relevant field).
  • Reside within 50 miles of the USAO Detroit Office.
  • At least five years of demonstrated ability in a similar position.
  • Proficient in Microsoft Office applications.
  • Valid driver's license and dependable vehicle.
  • U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.
  • Ability to make responsible decisions on short notice and adapt to unexpected developments.
Preferred Qualifications
  • Law enforcement or related investigative experience.
  • Working knowledge of healthcare fraud enforcement, including the relationships between federal and state law enforcement, administrative partners, and contractors.
  • Proficient in the use of electronic document review platforms such as Relativity, Everlaw Eclipse, or other similar platforms.
  • Experience demonstrating the following capabilities:
    • Make contacts, maintain effective work relationships, and gain the confidence of others, including investigators from a variety of law enforcement agencies.
    • Develop source information, prepare for, and conduct thorough witness interviews, and prepare reliable, well-written documentation of interviews.
    • Plan and conduct complex investigations in an expeditious manner with a minimal amount of direction/control.
    • Obtain information and develop evidence by observation, interviews, and examining and analyzing records.
    • Independently develop investigations by, among other things, recommending additional records and investigative steps.
    • Review, understand and analyze financial, billing, and other reporting information and materials.
    • Communicate both orally and in writing in a clear, concise, and logical manner, including preparing graphical representations of findings and conclusions for use as exhibits and testifying in court.
    • Analyze and objectively evaluate relevant facts and documentary evidence to arrive at sound conclusions.
    • Develop, obtain, analyze, organize, and preserve relevant evidence for trial purposes.
Benefits
  • 401(k) plan.
  • 401(k) matching.
  • Dental insurance.
  • Health insurance.
  • Paid time off.
Work Environment
  • 8 hour shift.
Education
  • Bachelor's degree (required).
Experience
  • Civil fraud investigation experience (5 years, required).
Security Clearance
  • Confidential (preferred).
Ability to Commute
  • Detroit, MI (required).