Healthcare Fraud Investigator Job at 1st Choice, LLC, Detroit, MI

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  • 1st Choice, LLC
  • Detroit, MI

Job Description

1st Choice LLC is seeking a highly skilled and experienced Civil Pandemic-Related Health Care Fraud and Opioid Investigator to join one of our Federal law enforcement teams in Washington, DC. In this critical role, you will play a pivotal part in investigating and prosecuting complex cases related to pandemic-related healthcare fraud and opioid abuse.

DUTIES & RESPONSIBILITIES:

The Investigator shall perform the following job duties:
  • 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 demand
- 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
  • Other related duties as assigned and within scope
WORK SCHEDULE: Full-time, 8:30am – 5:00pm EST

BASIC QUALIFICATIONS & REQUIREMENTS:

The ideal Healthcare Fraud Investigator will meet the following basic requirements;
  • U.S. Citizenship and ability to obtain adjudication for the requisite background investigation
  • Bachelor’s Degree or higher in law enforcement/criminal justice (or another relevant field) 
  • Reside within 50 miles of the place of performance
  • At least (5) five years of demonstrated ability in a similar position
  • Experience and expertise in performing the requirements as identified above
  • Proficient in Microsoft Office applications
  • Valid U.S driver’s license and dependable vehicle
  • Ability to make responsible decisions on short notice and adapt to unexpected developments
PREFERRED QUALIFICATIONS:
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 o 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
  • A federal background investigation, including fingerprinting, drug screening, and a credit check, is required. Applicants who already possess a clearance are preferred.
1st Choice is a professional management consulting firm with more than two decades of experience delivering innovative consulting, technology, and staffing solutions to federal and commercial organizations throughout the United States. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law

Job Tags

Full time, For contractors, Local area,

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