Sergeant - Medicaid Fraud Investigation Unit

2 weeks ago


San Antonio, Texas, United States CAPPS, Inc. Full time
Position Overview

As a key member of the Medicaid Fraud Control Unit (MFCU) at CAPPS, Inc., you will engage in sophisticated criminal investigations related to Medicaid provider fraud and nursing home issues. Your role will involve collaborating with various law enforcement agencies to ensure compliance with state and federal regulations. CAPPS, Inc. is committed to providing exceptional legal representation and fostering a positive work environment for its employees.

Key Responsibilities
  • Conduct in-depth criminal investigations into Medicaid provider fraud, ensuring timely and professional handling of nursing home-related cases.
  • Plan and execute undercover operations, surveillance, and searches, while gathering and analyzing evidence to support investigative findings.
  • Establish and maintain productive relationships with external agencies and organizations to enhance the mission of MFCU.
  • Participate in team-based investigative efforts and contribute to a collaborative work atmosphere.
  • Train and mentor junior staff as needed, fostering a culture of continuous improvement.
  • Respond to emergency situations as required, providing on-call support.
  • Maintain up-to-date knowledge of relevant laws and regulations to effectively perform job duties.
  • Ensure the confidentiality and security of sensitive information.
  • Adhere to all organizational policies and procedures, particularly those related to ethics and integrity.
Qualifications:

Minimum Requirements
  • High school diploma or equivalent.
  • Completion of sixty credit hours from an accredited institution, or relevant experience in investigations, law enforcement, or related fields.
  • A minimum of four years of full-time criminal investigative experience as a licensed peace officer or comparable federal law enforcement officer.
  • TCOLE certification is required.
  • Proficient in Microsoft Office Suite.
  • Strong understanding of criminal investigative methodologies and principles.
  • Excellent oral and written communication skills.
  • Ability to manage multiple tasks and meet deadlines effectively.
  • Capacity to work in high-pressure situations and provide exceptional customer service.
Preferred Qualifications
  • Experience in white-collar crime investigations.
  • Familiarity with healthcare fraud statutes at both state and federal levels.
  • Proven track record in report writing and documentation within the MFCU framework.

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