Apply on Employer Site

Ardelle Associates · 2 weeks ago

Healthcare Fraud Investigator

Raleigh, NC

Full-time

Onsite

Senior Level

5+ years exp

Ardelle Associates is a veteran-owned company providing Consulting and Support Services to government agencies. They are seeking a highly skilled and detail-oriented Fraud Investigator to support the Department of Justice in Raleigh, NC, focusing on investigating health care fraud cases, analyzing documents, and collaborating with law enforcement agencies.

CommercialConsultingGovernmentLegalRecruitingTechnical SupportTraining

No H1B

U.S. Citizen Only

Hiring Manager

Wendy Nash Vlissides

Responsibilities

Develop an understanding of applicable federal, state, and local statutes, regulations, and guidance to the extent necessary to make sound decisions on the direction and scope of investigations

Analyze publicly available materials, governmental databases, and other such sources to identify possible violations of federal law. Conduct preliminary investigations to confirm such violations

Assist in the investigation of affirmative cases being handled by Assistant United States Attorneys, including the following: Identifying witnesses, Helping to create and implement an investigative plan, to develop strategy, and to provide direction to investigators from client agencies, Drafting and monitoring subpoenas and other document requests and demands, Reviewing and analyzing documents, Conducting interviews, 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, 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

Qualification

Fraud InvestigationDocument AnalysisMicrosoft OfficeHealth Care Fraud KnowledgeElectronic Document ReviewCommunication SkillsDecision MakingRelationship Building

Required

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

Law enforcement or related investigative experience

Working knowledge of health care 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

Confidential security clearance