Agent - Medicaid Fraud Control

Job Posting Title

Agency

Supervisory Organization

Job Posting End Date (Continuous if Blank)

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Estimated Appointment End Date (Continuous if Blank)

Full/Part-Time

Job Type

Compensation

Job Description

Title: Agent

Unit: Medicaid Fraud Control

Salary Range: $68,000 - $90,000, commensurate with experience and qualifications

Location of Work: Oklahoma City, OK

FLSA Status: Non-exempt

Schedule: Full-time

Position Description:

The Oklahoma Medicaid Fraud Control Unit (MFCU) is a state law enforcement division within the Oklahoma Attorney General’s Office, and its mission is to investigate and pursue enforcement actions against health care providers who have defrauded the Medicaid program or who have engaged in abuse, neglect, and/or exploitation of persons in the Medicaid system or residential health care facilities.  The MFCU has both civil and criminal enforcement powers. 

The successful candidate for this position will work as a member of an interdisciplinary team of investigative agents, auditors/analysts, and attorneys, seeking civil remedies such as financial restitution and penalties, divestment or forfeiture, and exclusions from the Medicaid system, and/or pursuing criminal enforcement actions such as fines, incarceration, and exclusions from the Medicaid system.  The successful candidate for this position should have sound judgment, strong investigative, research, and analysis skills.  The Agent serving in this position will consult with attorneys and analysts, take part in crafting and executing investigative plans, gather and review evidence, provide evidence and other information to attorneys and analysts, and testify as needed.   Additionally, the position may involve taking part in investigations and enforcement actions conducted jointly with Federal counterparts at any of the three U.S.  Attorney Offices located in Oklahoma.  This position may also involve lending assistance to Medicaid Fraud Control Units in other States and Territories across the country as may be needed.  

Agents of the Oklahoma Attorney General’s (OAG) Office are commissioned state law enforcement officials tasked with investigating violations and alleged violations of criminal and civil Oklahoma state statutes.  As the sole state law enforcement entity under the Oklahoma Attorney General, OAG Agents have the unique investigative and prosecutorial advantage of working with, and collaborating with, state OAG Assistant Attorneys General  on a daily basis.  As commissioned state law enforcement officials, OAG Agents are automatically enrolled in, and designated beneficiaries of, the Oklahoma Law Enforcement Retirement System (OLERS).  To help ensure OAG Agents can fulfill their responsibilities to the citizens of Oklahoma as state law enforcement officials, OAG Agents are subject to medical and physical fitness evaluations.

The agent accepting this position must maintain the integrity of the Attorney General’s Office, as well as the confidentiality of information as required by the Oklahoma Attorney General.  In-state travel, including some overnight travel, is expected.  Also, out-of-state training opportunities will be available.

Essential Functions: 

·         Develop investigative plans and investigate cases as part of a team of Agents, Supervisory Agents, Analysts, and Assistant Attorneys General as part of the MFCU team

·         Communicate and collaborate with other Agents, Supervisory Agents, Analysts, and Assistant Attorneys General as part of the MFCU team

·         Attend MFCU-specific training programs on an ongoing basis

·         Interview witnesses, victims, and suspects, and then document investigative efforts and findings

·         Maintain organized and complete records of investigative work and time expended

·         Effectively and professionally research, prepare, analyze, and understand complex information and legal issues.

·         Effectively manage a varying caseload of investigations of different types and levels of urgency

·         Maintain the integrity of the Attorney General’s Office as well as the confidentiality of information as required by the Attorney General.

·         Exercise sound judgment, and exhibit excellent report writing skills

·         Prepare and provide testimony in courtroom settings

·         Execute search and arrest warrants

·         Maintain safety protocols of the Office of Attorney General

Required Qualifications: 

Qualified individuals must:

·         Be a CLEET certified peace officer in Oklahoma, or eligible to become a CLEET certified peace officer through reciprocity or successfully meeting and completing the standards and requirements of the Council on Law Enforcement Education and Training (CLEET) to become a certified peace officer in Oklahoma.  (This may include the successful admission to, and completion of, the CLEET Academy)

·         Possess a valid Oklahoma driver's license

Preference will be given to individuals with:

·         A bachelor’s degree

·         At least four years of investigative experience

·         Accounting Experience

·         Medical experience

·         Experience with complex financial matters

·         Experience investigating financial crimes

·         Experience investigating fraud

·         Experience investigating situations involving vulnerable victims such as the elderly, children, or the mentally and/or physically impaired

Physical Demands:

Incumbents in this position will be required to take and pass a medical physical examination and a rigorous physical fitness evaluation.  The physical fitness evaluation includes, but may not be limited to, push-ups, sit-ups, 300-meter sprint, and a mile and one-half run.  As a state law enforcement official, this position regularly requires effective utilization of all extremities, the ability to operate vehicles, objects or controls, and the ability to reach or extend hands and arms.  OAG Agents are expected to communicate effectively orally and to hear adequately within the context of interview, interrogation, and court room settings. Agents are required to be able stand, walk, stoop, kneel, crouch, and lift 50 pounds.  As a state law enforcement official, an OAG Agents is expected to work effectively in different types of environmental settings including, but not limited to, offices, outdoors, and extreme or hazardous weather conditions.

Mental Demands:

While performing the duties of this position, the employee must be able to use written and oral communication skills; read and interpret data, information and documents; interpret policies and procedures; learn and apply new information or new skills; work under deadlines with some interruptions; effectively organize and conduct multiple and distinct investigations,  interact well with OAG staff and other organizations; and interact effectively with suspects, victims, other law enforcement officers, Court officials, and the general public.  The incumbent will be required to take and pass a preliminary psychological assessment (MMPI).

Work Environment:

As a state law enforcement official, OAG Agents are expected to work effectively in different types of environmental settings including, but not limited to, offices, courtrooms, outdoors, vehicles, and extreme or hazardous weather conditions.  The incumbent needs to have the ability to operate in a professional office environment and use standard office equipment such as computers, telephones, photocopiers, filing cabinets, and fax machines.  This position frequently calls for the incumbent to work outdoors, and within their vehicle, for long hours during all seasons.  The incumbent must have the flexibility to work non-traditional work hours such as nights, weekends, and holidays when needed.

Stevens Amendment Statement:

The Oklahoma Attorney General’s Office Medicaid Fraud Control Unit receives 75% percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $4,527,129.64 for Federal fiscal year (FY) 2024. The remaining 25% percent, totaling $1,509,367.95 for FY 2024, is funded by the State of Oklahoma. The federal fiscal year 2024 is defined as October 1, 2024, through September 30, 2025. 

Equal Opportunity Employment

The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability.

Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub.