Criminal Justice Specialist II, Medicaid Investigations

Job title: Criminal Justice Specialist II, Medicaid Investigations

Company: State of North Carolina


Job description: Description of WorkNot sure you meet all listed requirements? Let our team take a look. Research shows that women and members of other under-represented groups tend to not apply to jobs when they think they may not meet every qualification. We are committed to creating a diverse and inclusive environment and strongly encourage you to apply.THE STARTING SALARY FOR THIS POSITION IS LIMITED TO $45,926 to $55,457. Salary offers for the selected candidate are based on the candidate’s education and experience related to the position, as well as our agency budget and equity.
This position is located in the Medicaid Investigations Division of the Department of Justice. The Attorney General’s Medicaid Investigations Division investigates and prosecutes health care fraud committed by Medicaid providers and the physical abuse of patients and embezzlement of patient funds in Medicaid-funded facilities. These cases protect and recover taxpayers dollars that can be used to provide needed medical services to Medicaid enrollees. These cases also protect our most vulnerable elderly and disabled citizens.The primary purpose of this position is to provide criminal intelligence and data analysis, data organization and data presentation assistance to Medicaid Fraud Financial Investigators in investigations of Medicaid fraud and abuse. This position will assist the Medicaid Fraud Financial Investigators and one or more teams of attorneys and investigators in the detection, investigation, and punishment of fraudulent and non-fraudulent violations of applicable criminal and civil laws pertaining to fraud and abuse by Medicaid providers and in administration of the Medicaid Program.This position will also support the investigation of Medicare and other federal health care fraud cases and investigations which are primarily related to Medicaid fraud involving complex financial analysis. This individual will

• prepare detailed spreadsheets and charts, review medical records, prepare written investigative reports, research public records, analyze facts and documents, and assist in the collection and storage of evidence.
• receive, document, research, gather information, and prepare reports of referrals from citizens, providers, recipients, and other professionals within and outside of the Medicaid agency who report Medicaid fraud abuse.
• must be able to suggest leads to investigators and assist in preparation of investigative requests for records, subpoenas and search warrants.
• must also perform administrative duties to include preparation of management reports and other duties as needed.
• This investigator typically works in the office, but may occasionally be required to work in the field to obtain pertinent information.

The successful candidate must undergo and successfully complete a comprehensive background check as part of the hiring process.Note to Current State Employees:
The salary grade for this position is NC12. State employees are encouraged to apply for positions of interest even if the salary grade is the same as, or lower than, their current position. Please detail ALL work history including non-state service experience. If selected for this position, a new salary will be recalculated taking into consideration the quantity of relevant education and experience, funding availability, and internal equity. Based upon these factors, a pay increase MAY or MAY NOT result.The State of North Carolina offers employer paid health insurance plus twelve paid holidays, generous vacation and sick leave accrual, dental, vision, and other insurance options, and retirement benefits. You can view our benefits information at .Department Information:
The , led by the Attorney General of North Carolina, represents the state, state agencies, and elected officials, and defends the rights of the people of North Carolina. The Department handles all state criminal appeals cases and assists district attorneys with complex criminal cases at their request. Additionally, the Department of Justice includes the , the , and the and .Knowledge, Skills and Abilities / Competencies

• Knowledge and understanding of the goals and objects of the Division, Department of Justice, Department of Health and Human Services, and other agencies involved in Medicaid services and regulation, and a thorough knowledge and understanding of all Division administrative and operational functions, policies and procedures and knowledge of criminal justice and law enforcement procedure, terminology, and personnel policies and practices.
• Must have the ability to learn and adapt to ever-changing computer software; the ability to provide written and oral briefings, reports and training to law enforcement agencies on trends and patterns of criminal activity and new and existing analytical techniques in criminal intelligence; the ability to exercise judgment and discretion in establishing, applying and interpreting policies, procedures, and administrative rules; and the ability to establish and maintain effective working relationships with multi-agency personnel and administrators.

Strong skills in utilizing word processing, spreadsheet, and database software, email functions, and Internet Web browser skills. The employee must have knowledge of modern office procedures, practices, and equipment including Word, Excel, Access, email, Internet browsers, relational databases, and an effective working knowledge of Medicaid coverage policy and claims processing and data systems and strong organizational skills and file management skills. .Minimum Education and Experience RequirementsBachelor’s degree from an appropriately accredited institution and two years of administrative and/or technical experience in criminal justice or law enforcement as it relates to the area of assignment, or an equivalent combination of education and experience.Supplemental and Contact InformationNote the following: If multiple applications are submitted to an individual posting, only the most recent application received prior to the closing date will be accepted. Applications must be submitted by 5:00 PM on the closing date.Resumes and cover letters: To receive credit for your work history and credentials, you must list the information on the online application form. This information is used to determine if you meet the requirements of the position, and if you are selected, it is used to determine a salary offer.Using the terms “See Resume” or “See Attachment” will not be accepted, and your application will be rejected as incomplete. Cover letters are highly encouraged but not required.Transcripts: Degrees must be received from appropriately accredited institutions. A copy of your transcripts indicating the degree received can be uploaded with your application. If a transcript has been requested, your application will be considered incomplete if you do not provide one. Using a photograph of your diploma is not acceptable.Credit for foreign degrees will only be given if verification of degree certification is attached to your application. Transcripts for foreign degrees have to be evaluated by an organization like World Education Services to determine US equivalency.Any licenses or certificates must be included in the appropriate section of the application form.Applicants seeking Veteran’s Preference must attach a copy of their DD-214 or discharge orders.Applicants seeking National Guard Preference must attach a NGB 23A (RPAS) if you are a current member of the NC National Guard in good standing. If you are a former member of the NC National Guard who served for at least 6 years and was discharged under honorable conditions, you must attach either a DD256 or NGB 22.Application status: To check the status of your application, please log in to your account. Upon the closing date, applications are “Under Review” and will be screened by Human Resources for the qualified applicants. The hiring process may take an average of 6 – 8 weeks. All applicants will be notified by email once a position is filled.If you are having technical issues submitting your application, please call the NeoGov Help Line at 855-524-5627. If there are any questions about this posting, other than your application status, please contact the NC DOJ Human Resources office.The NC Department of Justice is an Equal Opportunity Employer. The NC Department of Justice uses Merit-Based Recruitment to select from among the most qualified applicants to fill positions subject to the State Human Resources Act.CONTACT INFORMATION:NC Department of JusticeHuman Resources OfficeNOTE: For temporary, contract or other supplemental staffing appointments: There are no paid leave, retirement or other benefits associated with these appointment types. For permanent and time-limited appointments:
Eligible employees have benefits that include employee health insurance options, standard and supplemental retirement plans, NC Flex (a variety of high-quality, low-cost benefits on a pre-tax basis), and paid vacation, sick, and community service leave, to name a few. Paid parental leave is available for eligible employees. Some benefits require 30 + hours work/week for participation.

Expected salary: $45926 – 80369 per year

Location: Wake County, NC

Job date: Sat, 07 Jun 2025 07:38:25 GMT

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