Healthcare Fraud Investigator

Classification:

This position is an OCSEA position and is subject to the Collective Bargaining Agreement. This position is classified as a BWC Fraud Investigator (26261) and the associated pay range for this position is Pay Range 32.

BWC is currently operating under a hybrid schedule that may incorporate both teleworking and in-person office hours. Employees must be able to report to the office when requested by management &/or for their initial job training.

What our employees have to say:

• BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
• I have worked at several state agencies and BWC is the best place to work.
• Best place to work in the state and with a sense of family and support.
• I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.
• I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.

If you are interested in helping BWC grow, please click this link to read more, and then come back to this job posting to submit your application!

What You’ll Be Doing:

• Interview subjects of health care fraud investigations to obtain statements, affidavits &/or confessions
• Interviews & documents contact with other individuals (e.g. informants, witnesses, physicians, attorneys, victims) associated with allegations of health care fraud.
• Collects & preserves all evidence to support case findings
• Prepare concise, accurate & detailed investigative reports
• Operate a personal computer (e.g. develops & maintains databases, creates & maintains spreadsheets, enter all investigative activities, searches internet to locate resources) daily
• Conduct covert surveillance and undercover activities to identify fraudulent activity perpetrated by health care providers

Why Work for the State of Ohio:

At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:

• Medical Coverage
• Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
• Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
• Childbirth, Adoption, and Foster Care leave
• Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
• Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation)

Qualifications:

• Completion of associate core program in criminology, criminal justice, or law enforcement; 18 mos. exp. in conducting criminal investigations.

• Or, for positions focused on forensic accounting/auditing: Completion of associate core program in forensic accounting/auditing or accounting: 18 mos. exp. in performing forensic accounting/auditing duties.

• Or equivalent of Minimum Class Qualifications For Employment noted above.

Job Skills: Investigation

Major Worker Characteristics:

Knowledge of: criminology, criminal justice, or law enforcement; BWC*, state & &/or federal statutes, rules, regulations & procedures applicable to investigations; evidence gathering & search & seizure; public relations; interviewing; case preparation; LEADS operator rules & regulations*; human relations. Skill in: operation of personal computer, database & spreadsheet software; analytical software used in fraud detection*; surveillance equipment (e.g. cameras, camcorders, mini cameras, undercover audio/video recording devices) *.

Ability to: define problems, collect data, establish facts & draw valid conclusions; prepare meaningful, concise & accurate reports; conduct interviews effectively; assess immediate situation & make split-second decisions; handle sensitive inquiries from & contacts with officials & general public; safely handle irate &/or dangerous citizens; recognize unusual or threatening conditions & take appropriate action; independently deal with many variables during investigative process;

Supplemental Information:

EEO & ADA Statement: The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes.

BWC OCSEA Selection Rights: This position shall be filled in accordance with the provisions of the OCSEA Collective Bargaining Agreement.

Salary Information: Hourly wage is expected to be paid at step 1 of the pay range associated with the position for candidates who are new employees of the state.

Transportation: Position may require travel; therefore, persons occupying this position must be able to provide own transportation &/or legally operate a state-owned vehicle.