Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
This position will remain open until filled.
Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by the passion to deliver comprehensive and cost effective health care to Arizonans in need. AHCCCS is nationally acclaimed as a model for other Medicaid programs and recipient of multiple awards for excellence in workplace effectiveness and flexibility. Visit our careers page to learn more about AHCCCS. Use your skills to benefit others; join the AHCCCS Team!
The Office of Inspector General is looking for a highly motivated individual to join our team as a Special Investigator. This position conducts complex criminal and civil investigations relating to allegations of Medicaid eligibility fraud. Major duties and responsibilities include but are not limited to:
* Conducts in-depth investigations that include field investigations, surveillance, interviewing and interrogating subjects or witnesses in their home or agency’s office.
* Serves Subpoena’s to obtain necessary evidence to prove or disprove allegations of Medicaid Fraud.
* Conducts investigative internet searches, uses and interprets other investigative sources such as; ACJIS, Experian Credit Reports, CLEAR, Lexis Nexus, Vital Records, AZ Corp. Commission, NWSC, AZ MVD reports, etc.
* Collects, examines, and preserves information, documents, and records for evidence.
* Interprets applicable, federal and state laws, agency rules, regulations and policy regarding Medicaid eligibility and criminal violations.
* Compiles, analyzes, organizes, Medicaid eligibility records, financial records and other related documents; Composes detailed reports of investigations to submit to prosecuting agencies for criminal prosecution and/or administrative action.
* This position also participates in special projects that may include out of town travel involving residency/eligibility checks of participants as well and on-site audits of certain high risk Medicaid providers. Must be willing to travel overnight if necessary.
* Computer literacy with working knowledge of Microsoft Word, Outlook, Excel, internet and investigative data and records
* Knowledge of Federal, State and agency laws, rules and regulations and gathering and organizing investigative case evidence/exhibits
* Ability to interpreting and applying Federal and State Statutes and Agency policies; Conduct investigations, including gathering evidence and conducting investigational interviews.
* Knowledge in proper methods of interviewing suspects, witnesses and victims, and of the rules regarding the admissibility of statements, admissions and confessions.
* Knowledge of criminal, civil and administrative law, Federal Medicaid/Medicare statutes, rules and regulations as they relate to Title 19, United States Code and knowledge of Arizona Revised Statutes, titles 13 and 36.
* Preference given to persons with: Past Law Enforcement Certification, or Certified Fraud Examiner Certification, or Medical or Health Care background, or 4 years of investigative experience, or a 4 year degree from accredited university in a closely related field.
* Any combination of training, experience, and education that meet the Knowledge, skills, and abilities (KSAs) may be substituted.
* Bilingual preferred but not required.
At AHCCCS, we promote the importance of work/life balance by offering workplace flexibility and a variety of learning and career development opportunities. Among the many benefits of a career with the State of Arizona, there are 10 paid holidays per year, accrual of sick and annual leave, affordable medical benefits and participation in the Arizona State Retirement Plan. Click here to learn more about benefits.
Arizona State Government is an EOE/ADA Reasonable Accommodation Employer.
All newly hired employees will be subject to E-Verify Employment Eligibility Verification.
Click the APPLY NOW button to submit your application.
For technical assistance, email [email protected] or call 602-542-4700.