Criminal Attorney III, Medicaid Investigations (65012757)

Description of Work Not 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.
This position is located in the Medicaid Investigations Division of the North Carolina Department of Justice.
Medicaid is the nation’s public health insurance program for people with low income.
This taxpayer funded program provides critical health coverage for nearly one in five people in North Carolina and is especially crucial for children.
Approximately 40% of children in North Carolina are covered by Medicaid.
In 2023, approximately $16.
9 billion was spent on Medicaid in North Carolina.
While the overwhelming majority of medical providers are honest and provide high-quality services, there are those who steal from the program, and those who abuse patients.
The Attorney General's Medicaid Investigations Division (MID) 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.
MID works closely with district attorneys’ offices, US Attorneys’ offices, federal, state and local agencies across the State.
The amount of loss (theft) in a Medicaid fraud case ranges from a few thousand dollars to tens of millions of dollars.
Every case helps protect and recover valuable taxpayer funds that are needed for their intended purpose of providing medical services.
We are looking for experienced, team-oriented prosecutors who believe in our mission of protecting patients and Medicaid funds.
The primary purpose of the Criminal Enforcement Attorney position is to prosecute criminal cases and assist with criminal investigations.
The criminal cases involve Medicaid fraud, patient abuse, and/or misappropriation of patient funds.
The Criminal Section will bring state and federal actions against Medicaid providers alleged to have committed complex health care fraud schemes.
The Criminal Enforcement Attorney position is also one of the attorney positions that fulfills the staff requirements of a MFCU contained in Title 42 of the Code of Federal Regulations, Section 1007.
13(a)(1), which mandates that the MFCU staff must include "one or more attorneys experienced in the investigation or prosecution of civil fraud or criminal cases, who are capable of giving informed advice in applicable law and procedures and providing effective prosecution or liaison with other prosecutors.
" Medicaid Investigations Division (MID) is staffed by Department of Justice attorneys, investigators, auditors, analysts, and a nurse investigator, paralegals, and administrative staff.
MID provides state and national training opportunities to aid employees in understanding the complexities of health care fraud investigations.
Cases are tried in state and federal court in partnership with law enforcement agents with federal and state agencies such the Office of Inspector General, FBI, IRS, NC SBI, Sheriffs' Offices, and Police Departments.
To date, the MID has recovered more than $1 billion in restitution and penalties for North Carolina.
The MID receives 75 percent of its funding from the U.
S.
Department of Health and Human Services under a grant award totaling $8,535,748 for Federal fiscal year (FY) 2024.
The remaining 25 percent, totaling $2,845,248 for FY 2024, is funded by the State of North Carolina.
Duties include: Thoroughly review all pertinent information relating to cases referred to the Division or generated by the Division.
Ensure investigations are conducted within the parameters and in accordance with current state and federal law and court rulings.
Determine whether there is a criminal violation of the law by thorough and precise analysis, research of documentary evidence, and interviews.
Analyze, review and prepare state and federal arrest warrants, indictments, and other pleadings necessary to the successful prosecution of charges initiated by the Division.
Initially, the Attorney III will prosecute almost exclusively in state court as a Special Prosecutor.
After gaining experience prosecuting health care fraud in state court and receiving training, the Attorney III may be required to prosecute cases as a Special Assistant United States Attorney (“SAUSA”) in federal court.
If required to prosecute cases as a SAUSA, the Attorney III will receive guidance from the United States Attorney’s Office, an Assistant United States Attorney or an experienced SAUSA.
This position does not require prior federal experience.
Supervise the preparation of cases.
Work with investigators to investigate cases and gather sufficient evidence to support the filing of an indictment or warrant.
Prepare discovery and analyze and respond to discovery requests and ensure that all discovery is provided as required by law.
Perform legal research in the field of health care fraud and investigations.
Organize trial documents to ensure their admissibility and to make them understandable to the court and jury.
Negotiate criminal pleas in complex criminal actions, prepare agreements for criminal restitution, and analyze financial settlements proposed by opposing counsel.
Provide legal guidance and direction to the investigators.
Provide consultation and advice to the Criminal Chief and Director; keep the Director and Criminal Chief apprised of important developments in criminal cases.
This position requires some overtime.
The North Carolina Department of Justice provides excellent representation and support to law enforcement, consumers, the State, and its people through teamwork, innovation, and a commitment to public service.
This position requires travel which may include overnight stays.
Note to Current State Employees: The salary grade for this position is LG08.
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 STARTING SALARY FOR A NEW HIRE TO THIS POSITION IS LIMITED TO $84,878 to $100,179.
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.
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 Employee Benefits.
Hybrid telework opportunities are available for this position.
Knowledge, Skills and Abilities / Competencies Ability to effectively bring and supervise investigations of health care fraud by providers of medical assistance under the state Medicaid Program and other health care programs.
Willingness and ability to develop a thorough knowledge of the following: The laws and regulations pertaining to health care.
The rules and regulations pertaining to Medicaid reimbursement and the administrative operation of health care facilities and professional medical offices.
The legal principles and techniques of conducting criminal investigations.
Ability to examine and analyze records.
Ability to present findings to judges and juries in a clear and orderly manner.
Ability to communicate effectively on medical and financial matters before a court and jury.
Ability to maintain an effective working relationship with judges, related federal and state agencies and administrators, and other legal and administrative staff within the Department of Justice, and the general public.
Able to satisfactorily complete a detailed federal agency national security personal background investigation in order to become eligible for appointment as a SAUSA.
Minimum Education and Experience Requirements Some state job postings say you can qualify by an “equivalent combination of education and experience.
” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both.
See oshr.
nc.
gov/experience-guide for details.
Licensed to practice law by the North Carolina State Bar and three years of progressively responsible professional legal experience.
NOTE: GS 114-2 and 114-6 make it the duty of the Attorney General of NC to represent the State of North Carolina in all litigation unless another statute specifically states otherwise.
Management preferences: Recent prosecutorial experience in North Carolina state courts as an ADA, special prosecutor, etc.
Supplemental and Contact Information The NC Department of Justice accomplishes our goals through our DOJ Organizational Values of Public Service, Integrity, Excellence, Teamwork, Diversity, and Innovation.
We encourage all qualified candidates who are committed to these values and want to make a difference in the lives of our citizens to apply for this opportunity.
Please be sure to complete the application in full.
Note 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.
Veterans Preference: 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.
NeoGov Help Line: 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 Justice Human Resources Office 114 W.
Edenton Street Raleigh, NC 27603 919-716-6490