State of Tennessee ยท 2 hours ago
ASSISTANT ATTORNEY GENERAL - CIVIL MEDICAID FRAUD DIVISION - 74009
Davidson County, TN
Full-time
Hybrid
Mid, Senior Level
3+ years expThe State of Tennessee is seeking an Assistant Attorney General for the Civil Medicaid Fraud Division. This role involves investigating and prosecuting civil cases of Medicaid fraud, working on complex cases in federal and state courts, and ensuring compliance with healthcare regulations.
AgricultureChildrenEducationGovernmentHealth Care
Responsibilities
Conduct investigations of healthcare providers, pharmaceutical companies, laboratories, manufacturers and other entities suspected of submitting false claims to TennCare and other state payers
Gather and examine billing records, medical documentation, contracts, and other relevant documents
Interview witnesses, whistleblowers (qui tam relators), and State personnel
Research and apply federal and state Medicaid laws, including the federal False Claims Act, TMFCA and TFCA
Analyze complex billing schemes and healthcare regulations to determine violations
Assist in developing litigation strategy and evaluating potential settlements
Draft legal memoranda, civil complaints, civil investigative demands (CIDs) and subpoenas
Participate in civil litigation from initial investigation through resolution, judgment or appeal as necessary
Prepare and file pleadings, motions, and legal briefs
Conduct discovery, including depositions and document review
Coordinate with the U.S. Department of Justice, state Medicaid agencies, and multi-state working groups
Oversee settlement negotiations
Work with internal divisions to ensure consistent enforcement across overlapping areas of authority
Liaise with TennCare, Medicaid program integrity units, and external stakeholders
Assist in compliance monitoring and post-settlement enforcement
Qualification
Required
Juris Doctor with at least three years of complex civil litigation experience
Strong knowledge of healthcare law and complex civil litigation in federal and state courts
Experience litigating cases under the False Claims Act, TMFCA and TFCA
Analytical skills for reviewing large datasets and complex financial/billing records
Excellent legal writing and research skills
Familiarity with governmental litigation procedures, including CIDs and e-discovery
Analytical thinker with attention to detail
Integrity and discretion, especially when handling sensitive health and financial information
Collaborative mindset, able to work effectively with investigators, nurse coders, data analysts and other attorneys
Persistence and initiative, willing to pursue multi-year, complex investigations and lawsuits
Communication skills, able to explain technical or legal findings clearly to non-legal audiences
Preferred
Prior experience in healthcare regulation preferred
Company
State of Tennessee
State government is the largest employer in Tennessee, with approximately 43,500 employees in the three branches of government.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Hugh Hale
Chief Information Officer, TennCare
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