Healthcare Fraud Investigator / Senior Civil Investigator Supporting the USAO

Reference #: 24-110

FSA Federal (FSA) is focused on delivering unsurpassed services in support of law enforcement and homeland security. We currently have a vacancy for a Senior Civil Investigator. In this role, you will be supporting the overall mission of the United States Attorney's Office (USAO). If you are looking for a meaningful, mission driven career, Join FSA!

The United States Attorney's Office Middle District of PA requires an investigator to support its investigations and litigation of civil healthcare fraud. The USAO regularly investigates and litigates matters involving fraud committed on public healthcare benefits programs, including Medicare, Medicaid, TRICARE, and the Federal Employees Health Benefits Program. #AGENT #MILITARYTypical duties include:

Independently plans and conducts investigations.

Investigates matters, independently or in conjunction with federal agents, to determine whether there have been violations of Federal Statutes, e.g., False Claims Act, Stark Law, and Anti-Kickback Act.

Based upon understanding of the Federal Statutes, works and regularly communicates with AUSAs to identify possible violations or causes of action, determines proof required to assist in affixing legal responsibility, and devises methods for obtaining, preserving, and presenting such evidence.

Decides upon the most effective methods for planning, scheduling, and conducting investigations, and identifies required resources. Recommends methods for conducting investigations, including interviews, subpoenas, and depositions. Secures participation of appropriate law enforcement agents in execution of these investigative methods.

Identifies and presents AUSAs with potential investigations through review of the news, databases, and regular communications with representatives of government agencies and private industry.

Contacts officials and other representatives.

Contacts federal, state, and local officials, as well as business representatives, to gather information, documents, and statements on current or potential investigations, as well as coordinate investigative activities.

Identifies, locates, and interviews witnesses. Conducts surveillance of suspects with appropriate law enforcement agencies. Communicates with counsel of subjects and witnesses.

Prepares appropriate memos and reports on contacts, interviews, and surveillance.

Examines, analyzes, presents, and secures evidence.

Examines documents, emails, policies, text messages, payrolls, financial statements, billing statements, invoices, correspondence, computer data, and other records pertaining to the transactions, events, or allegations under investigation.

Researches and reviews laws, rules, regulations, and policies to determine whether healthcare billings were improper. Identifies and interviews any relevant governmental or business representative pertaining to the propriety of the billings.

Traces funds derived from fraud and identifies assets of subjects.

Confirms authenticity of documents, corroborates witness statements, and otherwise builds proof necessary for successful litigation.

Arranges for the integrity of evidence through secure storage, preservation, organization, and indexing of voluminous physical and electronic evidence.

Regularly updates AUSAs on status of case. Prepares interim and final reports on progress of investigations for use by AUSAs and supervisory attorneys. Includes significant findings and conclusions, recommendations for additional investigative actions, and candid assessments of strengths and weaknesses of witnesses, documentary evidence, and other aspects of case.

Assists with preparation for litigation and trial.

Provides analytical advice and assistance with compiling documents and physical evidence, and creating charts, graphs, videotapes, and other audio-visual materials for use by AUSAs in motions and at trial.

Provides advice to AUSA on selection of witnesses and ensures their attendance through s bpoena or otherwise.

Testifies in court regarding investigations, as required.

A Sr. Civil Investigator must meet the minimum qualifications:

Minimum fifteen years of federal law enforcement experience, with demonstrated experience in healthcare fraud investigations.

Four-year undergraduate degree in accounting or finance and a CPA certification desirable.

Must have excellent written and oral communication skills.

Understand the rules of evidence and civil/criminal procedure, the admissibility and inadmissibility of evidence, the elements of the violation(s) under investigation, and other applicable policies.

Significant experience testifying in court matters.

Must possess a valid driver's license.

Ability to travel in support of investigations.

Demonstrated liaison/coordination skills.

Proficiency in using a spreadsheet and word processing software.

Ability to consistently deliver the highest quality work under extreme pressure.

This position requires U.S. Citizenship and a 7 (or 10) year minimum background investigation.

Agency Overview

The USAO regularly investigates and litigates matters involving fraud committed on public healthcare benefits programs, including Medicare, Medicaid, TRICARE, and the Federal Employees Health Benefits Program. These investigations and cases often require additional investigative support, working in conjunction with the assigned federal agents, to investigate the facts and circumstances underlying the fraud, as well as litigate the cases.

Benefits Overview

At FSA Federal, we recognize the diverse needs of our employees and strive to provide an excellent package to help meet those needs. Comprehensive benefits are offered with greater choice and flexibility to support your health, work-life balance, and professional growth. A package providing employee only coverage can be built around our basic plans at $0 employee cost for: Medical, Dental, Vision, Term Life Insurance, Accidental Death & Dismemberment Insurance, Short-Term Disability, and Employee Assistance Program. For more information, click here.FSA is proud to be an Affirmative Action/ Equal Opportunity Employer. We recruit, employ, train, compensate, and promote qualified persons in all job titles without regard to age, ancestry, color, gender, HIV status, marital status, medical condition, national origin, physical or mental disability, race, religion, sex, sexual orientation (including gender expression and identity) veteran status, family leave status, and any protected group status as defined by applicable law. FSA is proud to maintain a drug-free workplace. Satisfactory completion of a post-offer drug screening is a condition of employment. As a supplier of services to federal government agencies, such as DEA, FBI, USCIS, USPIS, etc., we also adhere to agency standards with respect to prior drug usage. COVID Policy: As a Federal Government Contractor, FSA falls under the guidelines of Executive Order 14042 and the Safer Federal Workforce Taskforce. Prospective and/or new employees will be required to adhere with FSA's COVID -19 Policy and be fully vaccinated before the start of employment. If applicable, during the offer process, prospective or new employees may seek a reasonable accommodation due to a disability (which would include medical conditions) or because of a sincerely held religious belief, practice or observance. While at a Federal workplace, employees must also comply with any additional agency workplace safety requirements for that workplace.