Healthcare Fraud Investigator

Pay: $33.31 - $38.24 per hour

Ardelle Associates, a veteran-owned company providing Consulting and Support Services to government agencies is seeking a Civil/Health Care Fraud investigator to join their team in support of the DC Department of Justice (DOJ), U.S. Attorney's Office (USAO) in Raleigh, NC

We are seeking a highly skilled and detail-oriented Fraud Investigator to join our team. The ideal candidate should possess expertise in document analysis related to fraud cases and health care, exhibit proficiency in Microsoft Office applications, maintain U.S. Citizenship, and demonstrate the ability to make responsible decisions on short notice while adapting to unexpected developments

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 demands
• 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.

Job Type: Full-time

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off

Security clearance:
Federal Background check

Work Location:

In person

• Bachelor’s Degree or higher in law enforcement/criminal justice (or another relevant field)
• Reside within 50 miles of the USAO Raleigh Office
• At least five years of demonstrated ability in a similar position
• Proficient in Microsoft Office applications
• Valid driver’s license and dependable vehicle
• U.S. Citizenship and ability to obtain adjudication for the requisite background investigation
• Ability to make responsible decisions on short notice and adapt to unexpected developments

• 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
• 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
• 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.

Please send resumes to Wendy Vlissides