Assistant Division Director, Investigations Unit

Assistant Division Director, Investigations Unit

(Government Representative 2)

Medicaid Fraud Division

The Office of the State Comptroller (OSC) seeks an experienced attorney to serve as the head of MFD’s Investigations Unit. Reporting to the Director of MFD, this senior position will lead a team of attorneys and investigators responsible for detecting and preventing fraud, waste, and abuse in the Medicaid program. The ideal candidate will have significant prior experience in both litigation and conducting investigations.

RESPONSIBILITIES:

* Oversee the various functional teams within MFD’s Investigations Unit, including recipient investigations, provider enrollment, provider investigations, and special investigations.

* Review the Division’s policies, procedures, and practices, making recommendations for improvements where needed.

* Provide guidance to and ensures training for attorneys and investigators regarding obtaining evidence, sufficiency of evidence, investigative interviews and other investigatory techniques and practices.

* Coordinate with state and federal law enforcement and federal inspectors general regarding matters under investigation, including with regard to nursing homes, hospitals, and other healthcare providers.

* Identify potential investigative issues, subjects and targets. Prioritize and assign cases based on risk and other relevant factors.

* Lead staff in developing, reviewing and editing investigative plans and proposals.

* Oversee the drafting and issuance of public reports, making recommendations to state agencies involved in Medicaid and monitoring the implementation of MFD’s recommendations.

* Provide guidance on investigative and litigation strategies and issues; troubleshoots with staff to identify solutions.

* Develop expertise in applicable laws, rules, regulations and other standards related to the work of OSC and MFD; advise on the application of federal and state law.

* Communicate with various external stakeholders, including representatives from state and federal government and the healthcare industry.

* As part of a team, engage in a thorough and rigorous quality control process to ensure the accuracy and objectivity of investigative findings.

* Oversee MFD handling of cases referred for investigation, MFD referrals to outside agencies and law enforcement, and MFD responses to federal/state audits/reviews regarding investigation related information.

REQUIREMENTS:

* Graduation from an accredited law school with a Juris Doctor (J.D.) Degree.

* Membership in the New Jersey Bar in good standing.

* At least six years of experience as an attorney, with at least three years of supervisory experience.

* Experience with litigation and criminal or civil investigations, preferably in a supervisory capacity.

* Experience with litigation on behalf of or against state agencies.

* Experience in healthcare and/or New Jersey Medicaid strongly preferred, but not required.

* Ability to communicate complex quantitative and qualitative concepts.

* Excellent writing skills with an ability to draft, edit, and finalize a public report.

* Excellent public speaking skills.

* Leadership experience that involves developing and implementing a vision for holding other entities accountable, including through investigations and litigation.

Interested candidates should submit a cover letter, resume, writing sample and three (3) references to:

Paola Belardo
Office of the State Comptroller
P.O. Box 024
Trenton, NJ 08625
careers@osc.nj.gov

RESIDENCY REQUIREMENT:  Pursuant to N.J.S.A. 52:14-7 (L. 2011, Chapter 70), also known as the “New Jersey First Act,” all new public employees are required to obtain principal residence in the State of New Jersey within one (1) year of employment.

ABOUT OSC:

The Office of the State Comptroller (OSC) is an independent state agency that oversees the Executive Branch of state government. Our mission is to make the government in New Jersey more efficient, transparent, and accountable. Our office audits and investigates municipalities, school districts, and counties; state colleges and universities; independent state authorities; and state agencies. We also oversee government expenditures, review public contracts, evaluate local and state programs, and oversee New Jersey’s Medicaid program. We detect and uncover fraud, waste, and abuse and share our findings through public reports.

ABOUT THE DIVISION:

The Medicaid Fraud Division (MFD) oversees New Jersey’s Medicaid program. The Division identifies fraud, waste, and abuse by Medicaid providers, investigates acts of misconduct within Medicaid, makes criminal referrals involving Medicaid, and recommends changes to Medicaid policies implemented by other state agencies. MFD audits and investigates health care providers, recipients, managed care organizations (MCOs), contractors, and state agencies. MFD pursues civil and administrative enforcement actions and disqualifies providers from participating in the Medicaid program. 

New Jersey is an Equal Opportunity Employer.