Investigator Sergeant: Healthcare Fraud & Compliance Lead

State of Texas; Texas; On-site; USD 70,000 - 110,000; Full time

Job summary

Office of the Attorney General’s Medicaid Fraud Control Unit (MFCU) seeks a Sergeant to lead advanced criminal investigations of Medicaid provider fraud and nursing home cases.

The role involves working with other law enforcement agencies to pursue complex violations and provide prosecution support.

Qualifications

• High school diploma or equivalent required; 60 credit hours acceptable or degree substitution.
• Four years of full-time criminal investigative experience as a licensed peace officer or equivalent for the role.
• Knowledge of Texas Penal Code, Texas Code of Criminal Procedure, and applicable healthcare fraud statutes.

Responsibilities

• Conduct advanced criminal investigations of Medicaid provider fraud and nursing home-related matters.
• Collaborate with federal/state agencies (FBI, HHS-IG, IRS) on joint investigations.
• Provide prosecution assistance as needed and document findings.
• Pass background checks and be prepared for potential Top Secret clearance in some cases.

Skills

Oral and written communication

Investigative techniques

Strategic planning & budgeting

Firearms handling

OC spray & physical tactics

Criminal investigations

Statutes and court proceedings

Stress management

Team supervision

Education

High school diploma or GED

60 college credit hours or degree substitution

TCOLE certification

Tools

Microsoft Word

Excel

PowerPoint

Outlook

Job description

The Medicaid Fraud Control Unit is seeking a Sergeant whose work will involve advanced criminal investigations of Medicaid provider fraud and nursing home related investigations for the Office of the Attorney General¿s Medicaid Fraud Control Unit (MFCU). Work involves conducting criminal investigations of violations of various state and federal statutes and prosecution assistance as needed. OAG employees enjoy excellent benefits along with tremendous opportunities to do important work and make a positive difference in the lives of all Texans. The OAG is a dynamic state agency with over 4,000 employees throughout the State of Texas. As the State¿s law firm, the OAG provides exemplary legal representation in diverse areas of law. OAG employees enjoy excellent benefits (https://ers.texas.gov/Benefits-at-a-Glance) along with tremendous opportunities to do important work at a large, dynamic state agency making a positive difference in the lives of Texans. JOB POSTING NOTICE Applicants for this position should be prepared to pass a background investigation. Applicants will also be subject to a motor vehicle registration check. The MFCU works cases jointly with other law enforcement agencies including the FBI, U.S. Department of Health and Human Services - Inspector General and IRS. In certain cases, it is necessary for our staff to have a Top Secret security clearance in order to fully participate in joint investigations or in task force activities. Top Secret clearances are not required prior to employment but in certain cases may be required at a later date. Since most security clearance problems arise from criminal records or unresolved bad credit issues, full criminal and credit checks will be run on all applicants prior to employment.

Education: Graduation from high school or equivalent Education: Sixty credit hours from an accredited college or university; may substitute an associate¿s or bachelor¿s degree from an accredited college or university; or full-time investigations; law enforcement; auditing; accounting; compliance monitoring in Medicaid, Medicare, health care insurance, or closely related experience for the required education on a year-for-year basis Experience: Four years full time criminal investigative experience as a licensed peace officer or comparable federal law enforcement officer TCOLE certification Knowledge of TCOLE training requirements and healthcare fraud investigation training needs Knowledge of Microsoft Office products (i.e. Word, Excel, PowerPoint, Outlook) Knowledge of criminal investigative principles, techniques, and methodologies Knowledge of management and administrative principles, techniques, and methodologies Knowledge of agency goals, objectives, rules, regulations, policies, and procedures Knowledge of state and federal statutes, rules, and regulations pertaining to law enforcement activities Knowledge of criminal and civil court proceedings and rules of evidence Skill in effective oral and written communication (Writing sample will be required at time of interview, if selected) Skill in researching and interpreting complex rules and regulations Skill in applying investigative techniques and procedures Skill in handling multiple tasks, prioritizing, and meeting deadlines Skill in exercising sound judgment and effective decision making Ability to develop and implement strategic plans and budgets Ability to use and care for firearms Ability to use intermediate impact weapons and Oleoresin Capsicum spray Ability to use physical tactics Ability to conduct complex criminal investigations of Medicaid provider fraud and nursing home related investigations Ability to interpret and apply applicable provisions of the Texas Penal Code, the Texas Code of Criminal Procedure, and federal statutes pertaining to investigations Ability to interpret and apply department policies and procedures Ability to plan, assign, and supervise the work of others Ability to handle stressful situations Ability to receive and respond positively to constructive feedback Ability to work cooperatively in a professional office environment Ability to provide excellent customer service Ability to work in person at assigned OAG work location, perform all assigned tasks at designated OAG work space within OAG work location, and perform in-person work with coworkers (e.g., collaborating, training, mentoring) for the entirety of every work week (unless on approved leave) Ability to arrange for personal transportation for business-related travel, with reimbursement Ability to work more than 40 hours as needed and in compliance with FLSA Ability to lift and relocate 30 lbs. Ability to travel (including overnight travel) up to 20% Ability to achieve 64% or better of VO2 max on the 2000-meter row, or meet a minimum score of 64% on the 500-meter row test or 4-minute row test, utilizing a Concept 2 Rower Experience conducting white collar/economic crime investigations Experience investigating healthcare provider fraud and working with state and federal prosecutors in criminal matters Accomplished practitioner of the MFCU documentation and report writing system or a like system Knowledge of healthcare fraud statutes (state and federal)