Departmental Analyst 9-P11 - Healthcare Fraud Investigator - MDHHS OIG Integrity Division

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Departmental Analyst 9-P11 - Healthcare Fraud Investigator - MDHHS OIG Integrity Division

Salary

$25.10 - $39.33 Hourly

Location

Various, MI

Job Type

Permanent Full Time

Job Number

3947-24-OIG-10-FILL

Department

Health and Human Services - Central Office

Opening Date

10/07/2024

Closing Date

10/21/2024 11:59 PM Eastern

Bargaining Unit

NON-EXCLUSIVE REPRESENTED EMPLOYEE (NERE)

• Description

• Benefits

• Questions

Job Description

The MDHHS mission is to provide opportunities, services, and programs that promote a healthy, safe, and stable environment for residents to be self-sufficient. We are committed to ensuring a diverse workforce and a work environment whereby all employees are treated with dignity, respect and fairness. For more information, please visit ourMDHHS Diversity, Equity, and Inclusion Plan.

OFFICE OF INSPECTOR GENERAL (OIG) - CAREER BROCHURE (https://www.michigan.gov/documents/mdhhs/OIG_Career_Brochure4_668607_7.pdf)

This posting will be used to fill multiple vacancies in the following counties of the Integrity Division:Macomb,Oakland,Wayne,Central Region(Clinton, Eaton, Ingham),Thumb Region(Gratiot, Saginaw, Isabella, Midland, Bay, Clare, Gladwin, Arenac, Shiawassee, Genesee, Lapeer, Tuscola, Huron, Sanilac, St. Clair, Roscommon, Ogemaw, Iosco, Crawford, Oscoda, Alcona, Otsego, Montmorency, Alpena, Cheboygan, and Presque Isle), and Southern Region(Livingston, Jackson, Washtenaw, Hillsdale, Lenawee, Monroe)

As a Healthcare Fraud Investigator of the Office of Inspector General, this position investigates allegations of health services fraud, waste, and abuse for referral for administrative action and prosecution. This position assists in the overall planning, development, and direction of fieldwork, including fraud prevention and investigation involving programs administered by the Department of Health and Human Services (DHHS) for referral for criminal prosecution and/or civil recovery and repayment actions.

This position has the responsibility for complex investigations into allegations of fraud, waste and abuse involving Michigan's Health Services Programs, including Michigan's Medicaid Program, Mental Health Program, MIChild Program and Children's Special Health Care Services Program.

These investigations may result in referral to law enforcement agencies (e.g., Attorney General Health Care Fraud Division) for criminal prosecution.

The powers and duties of the Office of Inspector General include, but are not limited to, the following:

• Solicit, receive, and investigate complaints related to fraud, waste, and abuse in health services programs.

• Undertake and be responsible for MDHHS' duties under federal law with respect to fraud, waste, and abuse for the administration of the health services programs in Michigan.

• Actively seek out fraudulent billing practices of providers and develop techniques and procedures for detecting suspect billing patterns through the use of existing database resources managed by MDHHS and available from federal sources.

• Pursuant to Section 8 of The Social Welfare Act, 1939 PA 280, MCL 400.8, subpoena and enforce the attendance of witnesses, administer oaths or affirmations, examine witnesses under oath, and take testimony as the Inspector General deems relevant or material to an investigation, examination, or review undertaken by the Office.

• Require and compel the production of such books, papers, records, and documents as the Inspector General deems to be relevant or material to an investigation, examination, or review undertaken by the Office.

• Examine and copy or remove documents or records of any kind related to health services programs or necessary for the Office to perform its duties and responsibilities that are prepared, maintained, or held by, or available to, any state agency or local unit of government entity or contractor to a state agency or local unit of government.

• Pursue administrative and civil enforcement actions or collections against any individual or entity that engages in fraud, abuse, or illegal or improper acts or unacceptable practices perpetrated within health services programs, including but not limited to:

• Referring information and evidence to regulatory agencies and licensure boards.

• Excluding providers, vendors, and contractors from participation in the Medicaid program.

• Imposing administrative sanctions and penalties in accordance with state and federal laws and regulations.

• Pursuing any other formal or informal enforcement action relating to fraud, waste, and abuse that MDHHS is authorized to take under state or federal law, including, but not limited to, any actions under Sections 111 a to 111 h of The Social Welfare Act, 1939 PA 280, MCL 400.111 a to 400.111 h, or 1979 AC, R 400.3401 to 400.3425.

• Promptly provide information and evidence relating to suspected criminal acts to the Medicaid Fraud Control Unit of the Department of Attorney General, or any successor entity, to the extent required by federal law.

• Prepare cases, provide testimony, and support administrative hearings and other legal proceedings.

Position Description (https://MCSC.state.mi.us/AgencyPDFs/Composite Investigative Analyst 9-11 PD.docx)

Job Specification

To be considered for this position you must:

• apply for this position online via NEOGOV; click on "Apply" in the job posting for instructions on submitting your electronic application. Hard copy applications are not accepted.

• relevant experience and/or education referred to in the supplemental questions must be documented in the resume, transcript and/or application to allow for accurate screening.

• attach a resume identifying specific experience and dates of employment. Dates of employment should include month and year and hours per week.

• attach a cover letter.

• If applicable, attach a copy of an official transcript(s). We accept scanned copies of official transcripts. We do not accept web-based, internet, or copies of unofficial transcripts. Official transcripts provide the name of the institution, confirmation that a degree was awarded and on what date, and the registrar's signature. Please review Civil Service's guidelines regarding Official Transcripts:Official Transcripts (michigan.gov) (https://www.michigan.gov/-/media/Project/Websites/mdcs/neogov/OfficialTranscript.pdf?rev=0c57f92e150e4856b207ef348781c406)

Failure to complete any of the above may result in your application being screened out as incomplete. See instructions for attaching files here: Instructions (http://www.michigan.gov/documents/mdcs/New_Online_Employment_Application_Guide_-_First_Time_User_446027_7.pdf)

Required Education and Experience

Education

Possession of a bachelor’s degree in any major.

Bachelor's degree in Accounting, Criminal Justice, or a skilled medical related field, or a Juris Doctorate from an ABA accredited law school is preferred.

Experience

Three years of professional experience, including one year of experience equivalent to the experienced (P11) level in state service.

Alternate Education and Experience

Departmental Analyst 9 - 12

Educational level typically acquired through completion of high school and the equivalent of at least two years of full-time active-duty experience at or above the E-6 level in the uniformed services may be substituted for the education requirement.

Additional Requirements and Information

The use of artificial intelligence (AI) software of any kind is prohibited in all areas of the selection process; including, but not limited to, responses to application questions, and responses to interview questions or exercises.

If you previously held status in this classification and departed within the last three (3) years, please contact Human Resources regarding your interest in a potential reinstatement. Reinstatement is not guaranteed or required.

Your application for any position does not guarantee you will be contacted by the Department/Agency for further consideration. Only those applicants interviewed will be notified of the results.

Position Location/Remote Office: The office location for these positions will be at an MDHHS facility located inMacomb,Oakland,Wayne,Central Region(Clinton, Eaton, Ingham),Thumb Region(Gratiot, Saginaw, Isabella, Midland, Bay, Clare, Gladwin, Arenac, Shiawassee, Genesee, Lapeer, Tuscola, Huron, Sanilac, St. Clair, Roscommon, Ogemaw, Iosco, Crawford, Oscoda, Alcona, Otsego, Montmorency, Alpena, Cheboygan, and Presque Isle), and Southern Region(Livingston, Jackson, Washtenaw, Hillsdale, Lenawee, Monroe). Based on operational needs and within established limits, remote work and alternate or hybrid work schedule requests for this position may be considered.

Selected candidates who have been approved to work remotely or a hybrid schedule must complete that work within Michigan. Candidates should confirm work location and schedule at the time of interview.

Employees will be provided computers to perform state work. Phones may also be provided for necessary communications. If working remotely, employees will be responsible for providing other components of a remote office at their own expense, including:

• A secure work location that allows privacy and prevents distractions.

• A high-speed internet connection of at least 25 Mbps download and 5 Mbps upload.

• Suitable lighting, furniture, and utilities.

As a Condition of Employment: this position requires successful completion of a background investigation and a criminal records check. Due to the nature of this position, an additionalextensive background check will be conducted on candidates being considered for the vacancy.

The Department of Health and Human Services reserves the right to close this posting prior to its original end date once a sufficient number of applications have been received.

For information about the specific position, please emailMDHHSVacancies@michigan.gov . Please reference the job posting number in subject line.

Follow us onLinkedInfor more job opportunities.

MDHHSJobs#MDHHSJobs #Veteranfriendly #CareersWithPurpose #CommunityHeroes

MDHHS is proud to be a Michigan Veteran's Affairs Agency (MVAA) Gold Level Veteran-Friendly Employer.

State employment also offers rewarding careers where you can help Michiganders enjoy better lives. Many State of Michigan jobs offer alternate work schedules and remote-work options that can help give the flexibility you need. The State of Michigan has been recognized as a leading U.S. employer by new graduates from 2021-2023 and a best large U.S. and state employer. Recognized on the international stage for fostering positive employee engagement, the State of Michigan is a past recipient of a North America Government Agency Employees Engagement Award.

More details on benefits for our new hires are below:

Rewarding Work:State of Michigan jobs allow you to serve Michiganders in many different ways depending on your interests and skills. Help preserve and protect our environment and the public health; enforce state laws and regulations; advocate for children, families, and victims of discrimination; support our state’s military and veterans; rebuild our state’s infrastructure; or support other state agencies through our fiscal, IT, and HR systems.

Insurance Benefits:The State of Michigan offers health, mental health, dental, and vision insurance to eligible career employees, their spouses, and their children. The state also covers a life-insurance benefit of two times employees’ annual salary (up to $200,000). The state also offers long-term-disability insurance that can provide continuing benefits if an injury or illness prevents employees from working. More information is available atwww.mi.gov/employeebenefits.

Retirement Programs:The State of Michigan offers 401(k) and 457 plans for new hires to save for retirement. The state will automatically contribute an amount equal to 4% of your pay to a 401(k) account. The state will also match up to 5% of your pay if you contribute to your 401(k) account. Your contributions vest immediately, and the state’s contributions fully vest after just 4 years. More information is available athttp://www.mi.gov/orsstatedc.

Vacation and Sick Leave:Eligible full-time employees receive between15 and 35 personal daysand13 sick daysper year that may be rolled over to the following year if not used. Eligible employees also receive an additional day each year for community service or school functions.

Paid Parental Leave:Eligible employees can take12 weeks of paid leaveimmediately after a birth or adoption to allow needed time together at home with a new child.

Paid Holidays:Eligible employees receive 13 or 14 paid holidays each year including New Year’s Eve and Day, Martin Luther King Jr. Day, Presidents’ Day, Memorial Day, Juneteenth, the Fourth of July, Labor Day, Election Day, Veterans Day, Thanksgiving, Thanksgiving Friday, Christmas Eve and Day.

Bonus Programs:Eligible employees with five years of service also receive annual longevity bonuses that grow as seniority increases. Some positions also may qualify for recruitment, retention, and performance bonuses or other special pay premiums.

Military Pay Differential:Employees in the guard or reserves may also qualify for supplemental pay benefits if miliary pay during qualifying duty is less than normal state pay. Prior military service may also allow seniority credits to accelerate eligibility for longevity bonuses and additional personal leave accrual.

Tax-Advantaged Programs:In addition to 401(k) and 457 retirement accounts, the state also offers flexible spending account (FSA), health savings account (HSA), and qualified transportation fringe benefit (QTFB) programs that can help you save money by reducing your taxable income.

Student Loan Forgiveness:Working for the State of Michigan may allow you to participate in programs that forgive the balance of qualifying student loans.Information (https://studentaid.gov/manage-loans/forgiveness-cancellation) to help determine if you could qualify is available from the U.S. Department of Education.

Tuition Reduction:Some colleges and universities offer savings to eligible employees and family members to further their education while working for the State of Michigan.

Professional Development:To help develop your career, programs are available to apply for reimbursement of up to $2,000 a year for education and training for college course credits and non-degree programs.

Alternative and Remote Work Schedules:Depending on the nature of their duties, many state jobs offer flexible work schedules and remote or hybrid telecommuting options that can help obtain the work-life balance that you seek.

Great Lakes and Great Times:Michigan boasts four Great Lakes, 11,000 inland lakes, 36,000 miles of rivers and streams, 20 million acres of forests, 100 state and national parks and recreation areas, 1,300 miles of bike trails, 6,500 miles of snowmobile trails, the second-most ski areas in the nation, 650 public golf courses, 600 campgrounds, and an international dark-sky park—just for starters. Our cities offer concerts and cultural events, storied sports teams, education hubs, vibrant downtowns, one-of-a-kind craft beverages, and renowned restaurants for every appetite. From urban centers to beach towns to the great outdoors, the opportunities are endless. With your state salary and benefits and Michigan’s affordable cost of living, you can explore all that Michigan has to offer.

Updated: 2/28/24

01

DEPTALT - Do you possess one of the following? A bachelor's degree or higher in any major. If so, please attach a copy of your official college transcripts. OR at least one year of professional level experience in the state classified service. OR the Educational level typically acquired through completion of high school and the equivalent of at least two years of full-time active-duty experience at or above the E-6 level in the uniformed services may be substituted for the education requirement. Please attach a copy of your DD214.

• Yes

• No

  02

  DEPTALT – Please select your level of experience.

• None to one year of professional experience.

• One to two years of professional experience.

• Two to three years of professional experience.

• At least three years of professional experience.

  03

  Do you possess at minimum a bachelor's degree?

• Yes

• No

  04

  Do you have experience in audits and/or investigations?

• Yes

• No

  05

  Describe your experience in audits and/or investigations. if do not possess any, write "N/A".

  06

  Do you have experience using data analysis?

• Yes

• No

  07

  Describe your experience using data analysis. if do not possess any, write "N/A".

  08

  Describe your experience defending your conclusions. If you do not possess any, write "N/A".

  09

  What abilities do you have that you feel best qualifies you for this position?

  10

  DEI-Describe a time when you needed to work cooperatively with someone that did not share the same ideas as you.

  11

  This posting will be used to fill multiple vacancies. Please select the location(s) of interest below (you may select more than one location):

• Macomb

• Oakland

• Wayne

• Central Region (Clinton, Eaton, Ingham)

• Southern Region (Livingston, Jackson, Washtenaw, Hillsdale, Lenawee, Monroe)

• Thumb Region (Gratiot, Saginaw, Isabella, Midland, Bay, Clare, Gladwin, Arenac, Shiawassee, Genesee, Lapeer, Tuscola, Huron, Sanilac, St. Clair, Roscommon, Ogemaw, Iosco, Crawford, Oscoda, Alcona, Otsego, Montmorency, Alpena, Cheboygan, and Presque Isle)

  12

  Please select from the options below: (Please note, actions that have been expunged, formal counseling, and layoff actions need not be reported.) Please select all that apply.

• I have been dismissed within the last two years

• I have resigned in lieu of discipline or dismissal within the last two years

• I have been suspended without pay within the last two years

• I have received a written reprimand within the last two years

• I have received an unsatisfactory rating within the last two years

• I have signed a last chance agreement with MDHHS within the last two years

• I certify that none of the above circumstances apply to me

  13

  Do you have an Intentional Program Violation from the Department of Health and Human Services?

• Yes

• No

  14

  Do you have any substantiated cases of abuse or neglect reported on the Department of Health and Human Services Central Registry?

• Yes

• No

  15

  Do you have any objection to being finger printed or drug tested?

• Yes

• No

  16

  From the options below, which accurately describes your current status? (A current state employee works for an actual state department such as the Department of Corrections, the Department of Transportation, etc.)

• A current Michigan Department of Health and Human Services (MDHHS) employee.

• A Michigan Department of Health and Human Services (MDHHS) employee in layoff status.

• A current State of Michigan (non-MDHHS) employee.

• A State of Michigan (non-MDHHS) employee in layoff status.

• None of the above.

  17

  Are you a current Michigan Department of Health and Human Services (MDHHS) employee classified as a Departmental Analyst 9 to 12 and interested in moving to the same classification and level at one of the posted locations?

• Yes

• No

  18

  Did you attach a cover letter and a copy of your resume to your application? (Failure to do so may result in your application being screened out.)

• Yes

• No

  19

  Did you attach a copy of an official college/university transcript to your application? (Failure to do so may result in your application being screened out.)

• Yes

• No

  Required Question

Agency

State of Michigan

Department

Health and Human Services - Central Office

Address

Office of Human Resources

235 S. Grand Ave.

Lansing, Michigan, 48933

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