Investigator III

3 days ago

San Diego, California, United States Department of Justice Full time
Job Description and Duties

Are you interested in combating healthcare fraud using your analytical and quantitative skills? Does helping recover stolen funds from the Medi-Cal program and protecting our elderly from financial abuse sound intriguing? The Division of Medi-Cal Fraud and Elder Abuse Investigation section is seeking talented investigative auditors with diverse investigative and data management skills and a commitment to detect and combat fraud and elder abuse.

Duties
  • Investigate allegations of Medi-Cal fraud and financial elder abuse.
  • Utilize various law enforcement and government databases to gather intelligence data on pertinent subjects of the investigation, including Lexis-Nexis.
  • Analyze financial documents, and billing/claims data, perform bank account reconciliations to determine patterns of fraud, and calculate the amount of theft or loss to the Medi-Cal program utilizing computerized audit techniques with tools including Microsoft Office Suite and Bank Scan.
  • Trace and locate hidden assets and/or monies.
  • Determine an entity's corporate structure and conduct interviews with corporate staff.
  • Participate in health facility and nursing home inspections.
  • Review medical and business records to compile information on the victim and subjects of an investigation.
  • Interview victims, witnesses, experts, and interrogate suspects and perform any and all fieldwork needed for the investigation.
  • Document all investigative findings in Reports of Investigations and prepare declarations in support of search and arrest warrants.
  • Service of bank search warrants and participate in the execution of search warrants of physical locations.
  • Compile evidence as prescribed by law to substantiate allegations of fraud and abuse and prepare filing packages to submit to the Deputy Attorney General.
  • Testify in court as the primary investigator on an assigned case or as an expert witness (Prop 115 Certified).
  • Work joint investigations with DMFEA Special Agents and Deputy Attorneys General.
  • Work on joint investigations with our allied law enforcement agencies.
Working Conditions

Telework is available but is contingent on DMFEA's operational needs. Investigations Section staff are required to be in the office three days a week based upon DMFEA's operational needs. Telework requires California residency.

Special Requirements
  • The position requires the incumbent to pass a Modified Background Investigation prior to being hired.
  • A fingerprint check will be required.
  • Complete and pass Penal Code 832, arrests, search, and seizure training during probation.
  • Clearly indicate the JC and the title of this position in the 'Examination or Job Title(s) For Which You Are Applying' section on your State Application's first page.
  • The Department of Justice may consider a Training & Development (T&D) assignment for this recruitment. If you are applying for a T&D assignment, please note 'T&D' in the 'Examination or Job Title(s) For Which You Are Applying' section located on the first page of your State Application (STD 678) form.
  • Clearly indicate the basis of your eligibility in the 'Explanations' section on your State Application's first page.
  • If you are using education to meet the minimum qualifications for this position, you must submit a copy of your transcript or diploma. Unofficial school transcripts may be accepted during the application process; however, submission of official transcripts or your diploma is required prior to the appointment.

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