Investigative Auditor IV Specialist

Interested in fighting healthcare fraud using your analytical and quantitative skills? Seeking to help recover stolen funds, protect the Medi-Cal Program against false claims submitted for payment to the State of California and help protect the vulnerable population? The Division of Medi-Cal Fraud and Elder Abuse is looking for talented auditors with superlative data management and investigative skills and a commitment to detecting and combating fraud – this is an opportunity highly qualified applicants should not miss.

Duties:

1. Conducts complex civil audits and investigations for the Civil Section, including:

a. Work with auditors and attorneys from other state Medicaid Fraud Control Units and/or Federal Assistant United States Attorneys to combat global health fraud. Review and provide claims data of suspected activity and assist in civil remediation.
b. Obtains and analyzes information from Medi-Cal claims database(s) and other evidence obtained from a variety of sources associated with cases and complaints of alleged Medi-Cal provider fraud.

c. Identifies, gathers, and maintains voluminous data relevant to such allegations.

d. Estimating and calculating monetary losses to the Medi-Cal program, including determining the reasonableness of audit findings and evaluating such results through comparative analysis and independent third-party verification.

e. Conducting interviews, performing any and all fieldwork needed for the audit or investigation, compiling and evaluating competent evidentiary material, developing audit findings, preparing detailed reports of investigation and schedules of findings that result from investigative activities and records examinations.

f. Participating in meetings, depositions, and interviews with qui tam relators, investigative, legal, and managerial staff, as well as private law firms and various governmental agencies.

g. Developing forensic investigative strategies and identifying resources necessary to perform various audit and investigative assignments.

h. Collaborating with teams of attorneys, paralegals, support staff, investigators, agents and auditors, and other analysts both within and beyond the Division.

2. Utilizing computerized audit techniques with tools including MIS/DSS claims database, Business Objects, Medi-Cal Management Information System, Lexis-Nexis, Microsoft Office Suite, SAS Enterprise Guide to develop programs and other information for sampling, cost evaluations, determining patterns, and trend analysis.

3. Assisting in the preparation (including drafting) and service of subpoenas, as well as in the preparation of discovery requests and discovery responses.

4. Assisting in the preparation of matters set for hearing, settlement, and trial, including testifying in civil hearings, depositions, and trials both in person and by affidavit.

Please let us know how you heard about our position by taking this brief survey:

https://www.surveymonkey.com/r/P7X675V

You will find additional information about the job in the Duty Statement.

Salary

• $6,752 - $8,876/month

Qualifications

Minimum Requirements
You will find the Minimum Requirements in the Class Specification.

• INVESTIGATIVE AUDITOR IV (SPECIALIST), DEPARTMENT OF JUSTICE
• INVESTIGATIVE AUDITOR II, DEPARTMENT OF JUSTICE
• INVESTIGATIVE AUDITOR III, DEPARTMENT OF JUSTICE

Desirable Qualifications

In addition to evaluating each candidate's relative ability, as demonstrated by quality and breadth of experience, the following factors will provide the basis for competitively evaluating each candidate:

1. Technical Qualifications:

a. Extensive experience working NAMFCU cases and prior experience working as a Global Case team member.

b. Extensive experience and knowledge working with Medicaid Claims.

c. Experience in conducting complex financial and forensic audits and investigations, researching and interpreting complex rules and regulations, reviewing and analyzing accounting records and financial institution records, performing statistical analyses for large volumes of data, and testifying in court or administrative hearings

d. Proficiency in generating work products and/or spreadsheets using Excel and SAS tools

e. Ability to write and produce concise, professional documents and reports, and to express facts and conclusions precisely and clearly

f. Successful completion of college-level courses in elementary and intermediate accounting, auditing, and cost accounting, as well as statistics

g. Ability to work under limited supervision on multiple assignments within a team environment

h. Proactive in the identification and successful resolution of issues

i. Regularly exercise the highest degree of professional judgment, integrity, and maturity

2. Additional Desired Attributes:

a. Ability to work flexible, possibly extended hours, and to travel, as needed

Other Information

Additional Documents

• Job Application Package Checklist
• Duty Statement

Department Information

• These positions are located in the Division of Medi-Cal Fraud and Elder Abuse, Civil Section, San Diego Regional Office

• Please disregard the SROA/Surplus language below, as the Department of Justice requires applicants to submit their SROA/Surplus Letter if that is the basis of their eligibility.

• Individuals who are new to State service must have list eligibility in order to gain employment with the Department of Justice. To access examinations and obtain list eligibility, please click the following links below:

  • Investigative Auditor IV Exam Bulletin
  • Investigative Auditor III Exam Bulletin
  • Investigative Auditor II Exam Bulletin

• Additional exams and information can be found at:https://oag.ca.gov/careers/exams. For more information about the department, please visit the Attorney General’s website at www.oag.ca.gov.

• Please note that all new to-state employees will be given the minimum salary of the classification. For current state employees and/or those with reinstatement rights, your salary will be determined in accordance with the applicable laws, rules, and regulations.

• If you have questions regarding this job announcement, please contact DMFEA_Personnel@doj.ca.gov.

Special Requirements

• A fingerprint check will be required.
• Complete and pass Penal Code 832, arrests, search, and seizure training during the probationary period.
• Clearly indicate the JC-470392 and the title of this position in the "Examination or Job Title(s) For Which You Are Applying" section located on the first page of your State Application.
• Clearly indicate the basis of your eligibility in the "Explanations" section located on the first page of your State Application.
• If you are using education to meet the minimum qualifications for this position, you must submit a copy of your unofficial transcripts. Unofficial school transcripts may be accepted during the application process; however, submission of official transcripts or your diploma is required prior to appointment.

Application Instructions

Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.

Final Filing Date: 6/6/2025

Who May Apply

Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list or LEAP eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates apply.

Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process.Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).

How to Apply

Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at www.CalCareers.ca.gov. When submitting your application in hard copy, a completed copy of the Application Package listing must be included. If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below:

Address for Mailing Application Packages

You may submit your application and any applicable or required documents to:

Department of Justice
DMFEA Personnel
Attn: Anthony Doss (JC-470392)
2329 Gateway Oaks Drive
Sacramento, CA 95833

Address for Drop-Off Application Packages

You may drop off your application and any applicable or required documents at:

Department of Justice
DMFEA Personnel
Anthony Doss (JC-470392)
2329 Gateway Oaks Drive
Sacramento, CA 95833
08:30 AM - 04:30 PM

Required Application Package Documents

The following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:

• Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at www.CalCareers.ca.gov. All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
• Resume is required and must be included.
• Statement of Qualifications -

  A Statement of Qualifications (SOQ) is required. Applicants who do not submit an SOQ will not be considered for this position. The SOQ prompt is listed below.

Applicants requiring reasonable accommodations for the hiring interview process must request the necessary accommodations if scheduled for a hiring interview. The request should be made at the time of contact to schedule the interview. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this job posting.

Working Conditions

This position is available to be filled in San Diego, Mission Valley office, free covered parking available and near shopping and restaurants.

Telework is available but is contingent on DMFEA's operational needs. Telework requires California residency.

Contact Information

The Human Resources Contact is available to answer questions regarding the position or application process.

Human Resources Contact:
Anthony Doss
(916) 621-1796
DMFEA_Personnel@doj.ca.gov

Please direct requests for Reasonable Accommodations to the interview scheduler at the time the interview is being scheduled. You may direct any additional questions regarding Reasonable Accommodations or Equal Employment Opportunity for this position(s) to the Department's EEO Office.

EEO Contact:
EEO Officer
(916) 210-7580
EERROffice@doj.ca.gov

California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device.

Statement of Qualifications

a. In no more than two paragraphs, describe challenges you’ve encountered while working with large amounts of data and what you did to overcome those challenges.

b. In no more than two paragraphs, describe your experience working on a global case.

Additional Application Filing Information

Please note, if using the United States Postal Service for delivery, there is no guarantee that your application will be date stamped and will arrive by the final filing date. If your application does not have a postmark or date stamp and arrives after the final filing date, your application will not be accepted. Therefore, to ensure the timely delivery of your application, it is recommended that you use either electronic delivery, parcel service, or certified mail. Using one of these options will provide proof of delivery prior to the final filing date.

Equal Opportunity Employer

The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.

It is an objective of the State of California to achieve a drug-free work place. Any applicant for state employment will be expected to behave in accordance with this objective because the use of illegal drugs is inconsistent with the law of the State, the rules governing Civil Service, and the special trust placed in public servants.

California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device. Benefits

Please access this link for information on benefits afforded to employees who work for the State of California - https://www.calhr.ca.gov/Pages/California-State-Civil-Service-Employee-Benefits-Summary.aspx