Investigative Specialist

Description

Duties Description

The Division of Medicaid Investigations ensures the integrity of the Medicaid program by conducting investigations, recovering over payments, and implementing administrative sanctions. This position will be in the Recipient Investigations Unit and duties will include, but not be limited to:

• Investigating allegations and referrals of Medicaid fraud, waste, and abuse.
• Conducting investigations of Medicaid recipients who misuse, abuse and/or defraud the Medicaid system by submitting false application information to qualify for benefits.
• Participating in drug diversion activities or other actions that seek to defraud or abuse the Medicaid program statewide.
• Conducting field work including home visits, meetings with local departments of social services, and local law enforcement agencies.
• Interviewing subjects and witnesses to collect, analyze, and secure evidence.
• Drafting correspondences, referrals to other agencies, and information request letters.
• Collaborating with other investigative and professional staff to ensure program integrity.
• Testifying in administrative/criminal hearings as necessary.
  
  

Qualifications

Minimum Qualifications

Appointment to the Trainee 1 level requires:

Four years of investigative experience OR an associate degree and two years of investigative experience OR a bachelor’s or higher degree.

Appointment To The G-18 Level Requires

Six years of experience in a field investigative position conducting interviews of witnesses and others, taking written statements and affidavits, collecting and analyzing physical and documentary evidence, and preparing detailed written reports of investigative findings.

NON-QUALIFYING INVESTIGATIVE EXPERIENCE includes but may not be limited to: Experience in routine police patrol work, security guard or related security position, tax collector, collector of delinquent accounts, credit checker, legal assistant/attorney, hotel or store detective, loss prevention office, parole officer, correction officer, guard, inspector, or experience in adoption and/or foster care placement.

Substitutions for the full G-18 title: an associate degree in criminal justice or related field may substitute for two years of qualifying experience. A bachelor’s degree in criminal justice or a related field may substitute for four years of qualifying experience. Related fields include: law enforcement, police science, criminal justice administration, criminology, criminal investigation, police studies, public justice, forensic accounting, forensic psychology, forensic science, and economic crime management.

Preferred Qualifications

Excellent verbal and written communication skills. Experience conducting welfare fraud investigations related to suspected fraudulent receipt of benefits of public assistance programs. Proficient in Microsoft Office Suite and ability to learn new data systems. Ability to analyze and apply data to investigations. Knowledge of the Medicaid program and/or health insurance programs.

Additional Comments

Non-Competitive, permanent, full-time position. There will be minimal mandatory overtime. Candidates with no prior state history will start at a starting salary for the Trainee 1 position of $52,198. The starting salary for the full G-18 position is $65,001. The salaries are NON-NEGOTIABLE.

Routine travel throughout New York State is required to conduct fieldwork necessary to complete investigations. Must have a valid driver’s license or otherwise demonstrate the ability to meet the transportation requirements of the position.

Please be aware that because of the nature of the position, an appointment is subject to satisfactory completion of fingerprinting and a background check.