Complaint Assessment Attorney

State of California; California (MO); On-site; USD 150,000 - 210,000; Full time

Job summary

State of California's Division of Medi-Cal Fraud and Elder Abuse (DMFEA) seeks a Deputy Attorney General (DAG) to work on complex fraud and elder abuse cases within a multi-disciplinary CAT.

Under the Senior Assistant Attorney General, the DAG guides legal analysis, coordinates investigations, and liaises with law enforcement and health departments; position emphasizes advocacy, strategic prosecution, and compliance with Penal/Evidence codes.

Qualifications

• Excellent oral advocacy, legal research, and legal writing skills.
• Experience litigating complex cases, particularly fraud, throughout all stages, including jury trial.
• Knowledge of the healthcare industry, and the Medi-Cal program in particular.
• Knowledge of healthcare law and elder law, including Penal and Health and Safety code sections.
• Mastery of the rules of criminal procedure and evidence.
• Experience working with law enforcement personnel, auditors, and medical experts.
• Exemplary prosecutorial and professional ethics.

Responsibilities

• Organize, review, and evaluate DMFEA’s most complex complaints involving fraud and abuse.
• Evaluate complaint referrals to determine if further investigation is warranted and open matters for potential prosecution.
• Provide expertise and guidance on legal analysis, applicable laws, and investigation/litigation strategy.
• Maintain relationships with referral agencies and supervising personnel.
• Coordinate notifications to referring entities and collaborate with Outreach to build state-wide relationships.

Skills

Oral advocacy

Legal research

Legal writing

Litigation - complex cases

Healthcare law knowledge

Elder law knowledge

Criminal procedure

Evidence rules

Teamwork

Ethics

Job description

The Division of Medi-Cal Fraud and Elder Abuse (DMFEA) investigates and prosecutes, both criminally and civilly, health care providers who defraud the Medi-Cal program, providers who abuse or neglect Medi-Cal beneficiaries, and those who abuse or neglect elderly and dependent adults in care facilities.

As the legal subject matter expert on the Complaint Assessment Team (CAT) and under the direct supervision of the Senior Assistant Attorney General, the Deputy Attorney General (DAG) works closely within a multi-disciplinary team, to organize, review, and evaluate DMFEA’s most complex complaints involving fraud and abuse. CAT collectively evaluates complaint referrals to determine if further investigation by DMFEA is warranted, and if so, opens a matter for potential criminal or civil prosecution. The DAG shall provide expertise and guidance to the team relating to legal analysis, applicable laws related to fraud and abuse, including the California Penal and Evidence codes, criminal investigative and litigation strategy, federal performance standards, and the Division’s prosecution priorities. The DAG will maintain productive working relationships with local, state, and federal referral agencies, including law enforcement, the Department of Health Care Services, and the Department of Public Health as well as supervising personnel throughout DMFEA, including Special Agents-in Charge (SAC) and criminal and civil SDAGs. The CAT DAG will ensure that required formal and appropriate informal notifications are provided to referring entities at various points in the process and will coordinate with DMFEA Outreach to establish relationships with referral agencies throughout the state.

You will find additional information about the job in the Duty Statement.

Benefit information can be found on the CalHR website and the CalPERS website.

Minimum Requirements

You will find the Minimum Requirements in the Class Specification.

Desirable Qualifications

• Excellent oral advocacy, legal research, and legal writing skills
• Experience litigating complex cases, particularly fraud, throughout all stages, including jury trial
• Knowledge of the healthcare industry, and the Medi-Cal program in particular
• Knowledge of healthcare law and elder law, including applicable Penal and Health and Safety code sections
• Mastery of the rules of criminal procedure and evidence
• Experience working with law enforcement personnel, auditors, and medical experts
• Positive attitude, appreciation of teamwork, and an excellent work ethic
• Exemplary prosecutorial and professional ethics