SGI Global is seeking a part time Health Care Fraud Investigator to support the United States Attorneys' Office, District of Nebraska. The position is based in Omaha, Nebraska.
- Work with the assigned AUSAs and/or supervisory attorneys, determine applicable administrative statutory and regulatory law, and identify possible health care fraud violations or causes of action.
- Develop an understanding of all applicable federal, state or local laws to the extent necessary to make sound decisions on direction and scope of health care fraud investigations. Determine proof required to assist in affixing legal responsibility for litigation, and devise methods for obtaining, preserving, and presenting evidence to the greatest effect.
- Decide upon most efficacious methods for planning, scheduling, and conducting health care fraud investigations, and identify any resources that may be required.
- The health care fraud investigator will perform a variety of ancillary investigation related services in direct support of litigation.
- Initiate contacts with federal, state and local officials, and other organizations and individuals related to the subject of investigation, for the purpose of gathering facts, obtaining statements, learning sequences of events, obtaining explanations and otherwise advancing investigative objectives. Examine books, ledgers and payrolls, cost reports, billing statements, invoices, correspondence, computer data and other records pertaining to the transactions, events, or allegations under investigation. Establish and/or verify relationships among all facts and evidence obtained or presented to confirm authenticity of documents, corroborate witness statements, and otherwise build proof necessary for successful litigation.
- Arrange for secure storage, preservation, organization and indexing of voluminous documentary evidence while maintaining the confidentiality of individually identifiable medical information.
- Assist law enforcement agents in conducting interviews of witnesses. Identify the need for service of warrants and subpoenas, and secure participation of appropriate law enforcement agents in executions of same.
- Coordinate surveillance of suspects with appropriate law enforcement/investigative agencies. Occasional surveillance activities performed personally would occur in locations that are open and accessible to the public where there is little or no risk of physical harm to the investigator or others. The investigator will not have arrest authority nor would he or she be authorized in the use of deadly force. The investigator's work characteristically would not involve physical interaction with the subject or target of a criminal investigation.
- Prepare interim and final reports on progress of investigations for use by AUSAs and supervisory attorneys. Include significant findings and conclusions, recommendations for additional investigative actions, and candid assessments of strengths and weaknesses of witnesses, documentary evidence, or other aspects of case.
- Assist in compilation of documents and physical evidence, and creation of charts, graphs, videotapes, and other audio-visual materials for use by AUSAs in motions and at trial. Provide advice to AUSAs on selection of witnesses and ensure their attendance through properly obtained subpoena or otherwise. Testify in court regarding investigations, as required.
- Perform other related duties as assigned.
- Minimum of four years of experience in federal health care fraud investigations. Law enforcement experience is preferred.
- Working knowledge of current investigative techniques including the use of commercial databases and other sources of information.
- Experience in analyzing, organizing, and presenting a large volume of data through the use of common software programs is preferred.
- Experience in reviewing and understanding medical records and knowledge of medical billing procedures is preferred.
- Experience in interviewing potential witnesses is preferred.
- A four-year undergraduate degree is preferred.
- Must have a valid driver's license.
- U.S. Citizenship and a seven or ten year minimum background investigation.
SGI Global provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.