Health Care Fraud Examiner

**Recruiters, please do NOT contact Advent Services**

A leader in supporting clients in technically demanding industries, Advent's capabilities and services promote innovation & empower our partners to manage risk, protect the information, and achieve organizational objectives. We are proud of our ability to support mission-critical systems in every phase of their lifecycle to ensure our nation's forces can accomplish their mission.

Applicants must have good written and oral communication, interpersonal, problem-solving, analytical, and organizational skills. The ability to follow directions is a must. Applicants must work well alone and as part of a team.

Position: Health Care Fraud Examiner

Location: U.S. Attorney’s Office

                451 Florida St.

                Baton Rouge, LA 70801

Hours: Monday – Friday 8:00 a.m. to 5:00 p.m. CT

Purpose:

The Department of Justice, United States Attorney’s Office (USAO), Middle District of Louisiana (MDLA) has a requirement for Investigator Support Services to work within the Health Care Fraud Abuse and Control Program to assist in the generation of new investigations to continue with ongoing investigations, and to support civil actions to enforce federal laws or to recover federal funds lost to fraud, waste, or abuse.

Mandatory Qualifications:

• Four (4) year undergraduate degree or higher in statistical or data analysis, finance, accounting, or other related field.
• Minimum three (3) years of professional work experience planning and conducting complex investigations concerning the misuse of Government funds
• Proficient in Microsoft Office applications including Word, Excel, PowerPoint, Access,
• Familiarity with federal civil procedure and federal civil litigation
• Proficiency with data analysis techniques including outlier identification, use of statistical descriptors, creation and manipulation of Pivot Tables, and use of significance testing to review, summarize, and present data in connection with investigations
• Experience conducting witness interviews and preparing detailed, accurate investigative reports
• Experience analyzing, organizing, and presenting large volumes of data—both in hard-copy or electronic formats—such as bank records, financial records, healthcare claims data, and tax records
• S. Citizenship and ability to obtain adjudication for the requisite background investigation
• Experience and expertise in performing the requisite services in Section 3

Preferred Qualifications:

• Professional certification as a Certified Public Accountant (CPA), Certified Forensic Examiner (CRFAC), Certified Fraud Examiner (CFE), or a professional certification in a related area
• Relevant experience working with a federal or state legal or law enforcement entity

Tasks:

• Assist with the planning and conduction of investigations of a highly complex nature by performing quantitative, qualitative, or other analyses of relevant facts, and prepare results to support the mission of the HCFAC Program. Investigations may be conducted solely by the USAO, or in conjunction with federal or state agencies.
• Develop and analyze evidence and collect information relating to such evidence or legal matters under consideration from appropriate primary and secondary sources. Perform analysis to clarify the target suspect’s or organization’s pattern of operations, to identify information relevant to the legal issues involved, and to recommend valuable approaches to the AUSAs or other members of the investigative team. Develop and refine proof required to assist in determining legal responsibility for violations. Devise methods for effectively obtaining, preserving, and presenting evidence.
• Gather and analyze facts including statements, timelines, and scientific or technical data for the purpose of advancing investigative objectives. Establish and verify relationships among all facts and evidence obtained or presented to confirm authenticity of documents, corroborate witness statements, and otherwise build proof necessary for successful litigation.
• Provide specialized investigative analysis relevant to fraud on federal programs or federal civil rights violations
• Perform sophisticated analyses of large-scale hard-copy and electronic data, such as Health Care claims data, financial transaction data, accounting records, or bank records, to develop investigative leads.
• Assist with interviewing witnesses, depositions, and sworn witness examinations. Prepare detailed investigative reports for the case file. Reports shall include significant findings and conclusions, recommendations for additional investigative actions, and candid assessments of strengths and weaknesses of witnesses, documentary evidence, or other aspects of case.
• Assist with the preparation and service of subpoenas for documentary materials, interrogatory answers, or witness testimony in connection with HCFAC investigations.
• Conduct asset investigations, verify employment and conduct financial analyses to determine capability of targets to pay monetary penalties.
• Possess understanding of all applicable federal, state, or local law to the extent necessary to make sound decisions on direction and scope of investigations. Determine proof required to affix responsibility for violations, and devise methods for obtaining, preserving, and presenting evidence to the greatest effect.
• Work with the assigned Paralegal Specialists, AUSAs and supervisory attorneys to determine applicable statutory and regulatory law and identify possible violations.

Perform ancillary investigation-related services in support of assigned cases as follows:

• Utilize electronic databases to identify assets, documents, and other physical evidence.
• Arrange for secure storage, preservation, organization and indexing of voluminous documentary evidence.
• Assist in the compilation and analysis of documents and physical evidence, and the creation of charts, graphs, videotapes, and other audio-visual materials for use in motions and at trial. Provide advice to AUSAs on selection of witnesses and ensures their attendance through subpoena or otherwise.
• Communicate with federal, state, and local officials, and other organizations and individuals related to subject of investigation for the purpose of gathering facts, obtaining statements, learning sequences of events, obtaining explanations, and otherwise advancing investigative objectives. Examine books, ledgers, payroll records, cost reports, billing statements, invoices, correspondence, computer data and other records pertaining to the transactions, events, or allegations under investigation.
• Regularly meet with the HCFAC Coordinator and designated federal, state, and local officials or agency personnel for the purpose of Health Care Fraud and civil opioid investigations.
• Other related duties as assigned and within scope.

Advent's benefits program includes comprehensive medical, dental, and vision care, matching 401K, vacation time, sick time, life insurance, disability coverage, and other benefits that help financially protect you and your family.

Advent is an Equal Opportunity Employer. Employment decisions are not based on race, color, religion, sex, national origin, disability status, genetics, protected veteran status, or any other characteristic protected by federal, state, or local laws.