OAG - Medicaid Fraud Control Unit | Sergeant

General Description

The Medicaid Fraud Control Unit is seeking a Sergeant whose work will involve advanced criminal investigations of Medicaid provider fraud and nursing home related investigations for the Office of the Attorney General’s Medicaid Fraud Control Unit (MFCU). Work involves conducting criminal investigations of violations of various state and federal statutes and prosecution assistance as needed. OAG employees enjoy excellent benefits along with tremendous opportunities to do important work and make a positive difference in the lives of all Texans.

Applicants for this position should be prepared to pass a background investigation. Applicants will also be subject to a motor vehicle registration check. The MFCU works cases jointly with other law enforcement agencies including the FBI, U.S. Department of Health and Human Services – Inspector General and IRS. In certain cases, it is necessary for our staff to have a Top Secret security clearance in order to fully participate in joint investigations or in task force activities.

Top Secret clearances are not required prior to employment but may be required at a later date. Since most security clearance problems arise from criminal records or unresolved bad credit issues, full criminal and credit checks will be run on all applicants prior to employment.

• Conduct complex criminal investigations of Medicaid provider fraud and/or ensure nursing home related investigations are addressed professionally and in a timely manner, utilizing a wide range of techniques to accomplish the primary mission of MFCU, bringing violators of state and federal law to justice, and identifying Medicaid and related over payments to providers.
• Plan, participate in and conduct undercover investigations, surveillance operations, raids, searches; identify, gather, and examine evidence, including complex records of Medicaid providers; execute court orders, warrants, and subpoenas; and report investigative findings.
• Establish and maintain liaison with outside agencies, associations, groups, and others whose assistance and cooperation can enhance the mission of MFCU, including proactive generation of investigative targets; participate willingly in team investigative endeavors (intra‑Team, inter‑Team, inter‑city, and inter‑agency); and contribute to a positive work environment and high morale.
• May train, lead, and/or assist with the work of others.
• Perform related work as assigned.
• Respond to emergency situations by serving on‑call twenty‑four hours per day/seven days per week.
• Maintain relevant knowledge necessary to perform essential job functions.
• Attend work regularly in compliance with an agreed‑upon work schedule.
• Ensure security and confidentiality of sensitive and/or protected information.
• Comply with all agency policies and procedures, including those pertaining to ethics and integrity.

• High school graduation or equivalent.
• Sixty credit hours from an accredited college or university; may substitute an associate’s or bachelor’s degree or full‑time investigations, law enforcement, auditing, accounting, compliance monitoring in Medicaid, Medicare, health care insurance, or closely related experience for the required education on a year‑for‑year basis.
• Four years full‑time criminal investigative experience as a licensed peace officer or comparable federal law enforcement officer, TCOLE certification.
• Knowledge of TCOLE training requirements and healthcare fraud investigation training needs.
• Knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook).
• Knowledge of criminal investigative principles, techniques, and methodologies.
• Knowledge of management and administrative principles, techniques, and methodologies.
• Knowledge of agency goals, objectives, rules, regulations, policies, and procedures.
• Knowledge of state and federal statutes, rules, and regulations pertaining to law enforcement activities.
• Knowledge of criminal and civil court proceedings and rules of evidence.
• Skill in effective oral and written communication (a writing sample will be required at time of interview, if selected).
• Skill in…