Departmental Analyst 9-P11 - Healthcare Fraud Investigator (Wayne County) - MDHHS OIG
Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4929965)
Apply
?
Departmental Analyst 9-P11 - Healthcare Fraud Investigator (Wayne County) - MDHHS OIG
Salary
$2,008.00 - $3,146.40 Biweekly
Location
Wayne, MI
Job Type
Permanent Full Time
Job Number
3947-25-OIG-64-FILL
Department
Health and Human Services - Central Office
Opening Date
05/06/2025
Closing Date
5/13/2025 11:59 PM Eastern
Bargaining Unit
NON-EXCLUSIVE REPRESENTED EMPLOYEE (NERE)
Description
Benefits
Questions
Job Description
The MDHHS mission is to provide opportunities, services, and programs that promote a healthy, safe, and stable environment for residents to be self-sufficient. We are committed to ensuring a diverse workforce and a work environment whereby all employees are treated with dignity, respect and fairness. For more information, please visit our MDHHS Diversity, Equity, and Inclusion Plan.
OFFICE OF INSPECTOR GENERAL (OIG) - CAREER BROCHURE (https://www.michigan.gov/documents/mdhhs/OIG_Career_Brochure4_668607_7.pdf)
As a Healthcare Fraud Investigator of the Office of Inspector General, this position investigates allegations of health services fraud, waste, and abuse for referral for administrative action and prosecution. This position assists in the overall planning, development, and direction of fieldwork, including fraud prevention and investigation involving programs administered by the Department of Health and Human Services (DHHS) for referral for criminal prosecution and/or civil recovery and repayment actions.
This position has the responsibility for complex investigations into allegations of fraud, waste and abuse involving Michigan's Health Services Programs, including Michigan's Medicaid Program, Mental Health Program, MIChild Program and Children's Special Health Care Services Program.
These investigations may result in referral to law enforcement agencies (e.g., Attorney General Health Care Fraud Division) for criminal prosecution.
The powers and duties of the Office of Inspector General include, but are not limited to, the following:
Solicit, receive, and investigate complaints related to fraud, waste, and abuse in health services programs.
Undertake and be responsible for MDHHS' duties under federal law with respect to fraud, waste, and abuse for the administration of the health services programs in Michigan.
Actively seek out fraudulent billing practices of providers and develop techniques and procedures for detecting suspect billing patterns through the use of existing database resources managed by MDHHS and available from federal sources.
Pursuant to Section 8 of The Social Welfare Act, 1939 PA 280, MCL 400.8, subpoena and enforce the attendance of witnesses, administer oaths or affirmations, examine witnesses under oath, and take testimony as the Inspector General deems relevant or material to an investigation, examination, or review undertaken by the Office.
Require and compel the production of such books, papers, records, and documents as the Inspector General deems to be relevant or material to an investigation, examination, or review undertaken by the Office.
Examine and copy or remove documents or records of any kind related to health services programs or necessary for the Office to perform its duties and responsibilities that are prepared, maintained, or held by, or available to, any state agency or local unit of government entity or contractor to a state agency or local unit of government.
Pursue administrative and civil enforcement actions or collections against any individual or entity that engages in fraud, abuse, or illegal or improper acts or unacceptable practices perpetrated within health services programs, including but not limited to:
Referring information and evidence to regulatory agencies and licensure boards.
Excluding providers, vendors, and contractors from participation in the Medicaid program.
Imposing administrative sanctions and penalties in accordance with state and federal laws and regulations.
Pursuing any other formal or informal enforcement action relating to fraud, waste, and abuse that MDHHS is authorized to take under state or federal law, including, but not limited to, any actions under Sections 111 a to 111 h of The Social Welfare Act, 1939 PA 280, MCL 400.111 a to 400.111 h, or 1979 AC, R 400.3401 to 400.3425.
Promptly provide information and evidence relating to suspected criminal acts to the Medicaid Fraud Control Unit of the Department of Attorney General, or any successor entity, to the extent required by federal law.
Prepare cases, provide testimony, and support administrative hearings and other legal proceedings.
Position Description (https://MCSC.state.mi.us/AgencyPDFs/Wayne 1 Region Unit - Investigative Analyst 9-11 PD.docx)
Job Specification
To be considered for this position you must:
apply for this position online via NEOGOV; click on "Apply" in the job posting for instructions on submitting your electronic application. Hard copy applications are not accepted.
document relevant experience and/or education referred to in the supplemental questions in your cover letter, resume, transcript and/or application to allow for accurate screening.
attach a one-page resume identifying specific experience and dates of employment. Dates of employment should include month and year and hours per week.
attach a one-page cover letter.
If applicable, attach a copy of an official transcript(s). We accept scanned copies of official transcripts. We do not accept web-based, internet, or copies of unofficial transcripts. Official transcripts provide the name of the institution, confirmation that a degree was awarded and on what date, and the registrar's signature. Please review Civil Service's guidelines regarding Official Transcripts:Official Transcripts (michigan.gov) (https://www.michigan.gov/-/media/Project/Websites/mdcs/neogov/OfficialTranscript.pdf?rev=0c57f92e150e4856b207ef348781c406)
attach a writing sample (not to exceed two pages) that you have authored.
Failure to complete any of the above may result in your application being screened out as incomplete. See instructions for attaching files here: Instructions (http://www.michigan.gov/documents/mdcs/New_Online_Employment_Application_Guide_-_First_Time_User_446027_7.pdf)
Required Education and Experience
Education
Possession of a bachelor's degree in any major.
Bachelor's degree in Accounting, Criminal Justice, or a skilled medical related field, or a Juris Doctorate from an ABA accredited law school is preferred.
Experience
Departmental Analyst 9 - No specific type or amount is required.
Departmental Analyst 10 - One year of professional experience.
Departmental Analyst P11 - Two years of professional experience, including one year of experience equivalent to the intermediate (10) level in state service.
Alternate Education and Experience
Departmental Analyst 9 - 12
Educational level typically acquired through completion of high school and the equivalent of at least two years of full-time active-duty experience at or above the E-6 level in the uniformed services may be substituted for the education requirement.
Additional Requirements and Information
The use of artificial intelligence (AI) software of any kind is prohibited in all areas of the selection process; including, but not limited to, responses to application questions, and responses to interview questions or exercises.
If you previously held status in this classification and departed within the last three (3) years, please contact Human Resources regarding your interest in a potential reinstatement. Reinstatement is not guaranteed or required.
Your application for any position does not guarantee you will be contacted by the Department/Agency for further considera
