Demo

Medicaid Fraud Investigator (Investigator 3)

Department of Justice
Portland, OR Full Time
POSTED ON 3/25/2025
AVAILABLE BEFORE 5/24/2025
Initial Posting Date:
03/24/2025
Application Deadline:
04/14/2025
Agency:
Department of Justice
Salary Range:
$5,066 - $7,774
Position Type:
Employee
Position Title:
Medicaid Fraud Investigator (Investigator 3)
Job Description:
The Oregon Department of Justice is conducting a nationwide search for experienced investigators interested in joining our team as a Medicaid Fraud Investigator (Investigator 3). We are looking to hire one (1) non-sworn, permanent, full-time position. Our employees are currently working hybrid work schedules as business needs allow. The candidate selected for this position will do the same.

Health care fraud enforcement is a national priority. The Medicaid Fraud Unit of our
Civil Enforcement Division
investigates and prosecutes criminal and civil cases of fraud by Medicaid providers and allegations of abuse/neglect and financial exploitation of residents in long term care facilities. If selected, you will join DOJ as part of a dynamic, high-achieving, multi-disciplinary team charged with investigating and prosecuting health care fraud state-wide.

WHAT YOU WILL DO (in part)
  • Collect, evaluate, and analyze computerized data and other evidence (e.g., medical claims data, financial, records and legal documents).
  • Interview witnesses and suspects (including health care professionals, Medicaid agency personnel and Medicaid recipients).
  • Draft accurate, detailed reports of investigative findings and interview reports.
  • Properly and securely procure physical and documentary evidence.
  • Prepare graphs, charts, reports etc. for presentations.
  • Process referrals, conduct preliminary screenings, and make recommendations.
  • Researching Medicaid policies and programs.
  • Testify in grand juries, hearings, and trials.
  • Coordinate with other local/state/federal law enforcement entities.
REQUIRED ATTRIBUTES AND SPECIAL REQUIREMENTS
In order to be considered for this position, you must meet all of the following minimum qualifications.
  • Four years of recent (within last ten years) full-time investigative experience which included: 1.) conducting fact finding; 2.) collecting and preserving evidence according to the rules of evidence; 3.) examining records; 4.) locating and interviewing witnesses to verify or disprove claims of suspected law violations; 5.) and writing investigation reports sufficient for use at administrative hearings or in court. Examples of qualifying investigation experience are in areas such as law enforcement investigation, insurance investigation, investigative trial support, or financial fraud investigation. Work experience is based on a 40-hour work week. College-level courses in Law Enforcement, Criminal Justice, Law, Accounting, or Auditing may be substituted on a year-for-year basis for up to one year of the required experience.
  • Have and be able to maintain a valid driver license, throughout employment; willing and able to travel as needed (i.e., investigations, court dates, meetings, trainings, etc.).
  • Pass a computerized criminal history and driver and motor vehicle services check, as well as clear a comprehensive employment check. Adverse background data may be grounds for immediate disqualification.
DESIRED SKILLS AND ATTRIBUTES
  • Possess excellent analytical, communication, and organizational skills.
  • Experience interviewing witnesses and suspects, who are occasionally uncooperative and hostile.
  • Experience writing interview and investigative reports
  • Experience testifying in administrative, civil, or criminal proceedings.
  • Experience working as part of a multidisciplinary team.
  • Experience reviewing and analyzing financial records.
  • Expert-level in Microsoft Excel, and experience reviewing and analyzing data a plus!
  • Experience working for APS is a plus!
  • Experience with CPT codes is a plus!
The selection process consists of evaluating applicant’s education, level of experience, training, and overall professionalism within your application work history, resume, and cover letter. Follow the application directions, provide required documents which clearly showcase your skills. Do not attach extra documents. Details are important to us, your application materials will be evaluated for presentation, content, clarity, grammar, spelling, and applicable knowledge and skill(s). Those qualified candidates who most closely match the needs of the position and agency will be invited for an initial interview.
APPLICATION PROCESS
We strongly encourage all interested individuals to apply, and allow us to evaluate the knowledge, skills and abilities that you demonstrate, using an intentional equity lens. Candidates from diverse backgrounds are encouraged to apply. The Department of Justice is an equal opportunity employer, does not discriminate based on race, color, national origin, ethnicity, veteran, gender, sexual orientation, religion, age, or disability, and is committed to workplace diversity.
  • Click "Apply" and complete the online application and all supplemental questions.
  • Attach your resume.
  • Attach your cover letter.
ALL APPLICANTS: You will only have one opportunity to upload the required resume and cover letter. Drag and drop both resume and cover letter into Workday when prompted to upload your resume. If you are concerned that one or both required documents didn't attach to your application, if you need an accommodation under the Americans with Disabilities Act (ADA), have questions, or need assistance with the application process, please contact
doj.recruitment@doj.oregon.gov
. Any materials emailed will be associated on your behalf if received before the posting deadline.
CURRENT STATE EMPLOYEES: Login to Workday using your state-issued login and apply via the Jobs Hub Worklet located on your home page. Using a private account disrupts the hiring process for all internal candidates. Prior to clicking "Apply", update your employee profile to reflect your Education, Skills, and Job History (including your current job).
WHAT'S IN IT FOR YOU
  • Work/life balance to include 11 paid holidays a year, vacation, sick leave, personal business leave, and a
    competitive benefits package
    .
  • Excellent medical, vision, and dental.
  • Pension and retirement programs.
  • Job satisfaction as part of a team whose mission is to serve Oregon's public and government agencies.
  • Opportunity to work alongside State of Oregon leaders and impact change.
  • Work where individual contributions matter and are recognized.
  • An agency committed to equal opportunity and workforce diversity.
  • Representation and support by the Service Employees International Union (SEIU).
For more information about our benefits, you can learn
here
.
For additional information regarding working for the Department of Justice and application assistance,
click HERE.
Oregon Department of Justice
1162 Court St NE
Salem OR, 97301
DOJ.recruitment@doj.oregon.gov
Phone: (503) 947-4328
Fax: (503) 373-0367

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