Healthcare Fraud Investigator

CGS Federal (Contact Government Services) is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. This full-time, mid-level role requires initiative, attention to detail, accuracy under pressure, and a willingness to learn and apply knowledge to provide excellent litigation support to the client. Department:
Litigation Support. Base pay range: $85,000.00/yr - $/yr.

Employment Type:

Full-Time, Mid-Level.

• Review, sort, and analyze data using software programs such as Microsoft Excel
• Review financial records, complex legal and regulatory documents, summarize contents, and conduct research as needed; prepare spreadsheets of financial transactions (e.g., check spreads)
• Develop HCF case referrals including, but not limited to:
• Ensure that HCF referrals meet agency and USAO standards for litigation
• Analyze data for evidence of fraud, waste and abuse
• Review and evaluate referrals to determine the need for additional information and evidence, and plan a comprehensive approach to obtain this information and evidence
• Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based on applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings
• Assist the USAO in developing new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc
• Assist in conducting witness interviews and preparing written summaries

• Four year undergraduate degree or higher in criminal justice, finance, project management, or other related field
• Minimum three years of professional work experience in healthcare, fraud, or other related investigative field
• Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc
• Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (e.g., Medicare data, Medicaid data, outlier data)
• Communication skills: ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy
• U.S. Citizenship and ability to obtain adjudication for the requisite background investigation
• Experience and expertise in performing the requisite services in Section 3
• Must be a US Citizen
• Must be able to obtain a favorably adjudicated Public Trust Clearance

• Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3
• Relevant experience working with a federal or state legal or law enforcement entity

• Seniority level:
  Not Applicable
• Employment type:
  
  Full-time
• Job function:
  Legal
• Industries:
  Transportation, Logistics, Supply Chain and Storage