Investigator (Health Care Fraud)

Duties At the full performance level, you will independently plan and conduct complex investigations and/or financial examinations relating to health care fraud; involving Medicare, Medicaid, and other Federally subsidized health care programs, and participate in investigative activities with Federal, State, and local officials.
Typical work assignments will include (but are not limited to): Work with the assigned attorneys to determine applicable administrative statutory and regulatory law and identify possible violations or causes of action.
Compile documents and physical evidence, and creation of charts, graphs, videotapes, and other audio-visual materials for use in motions and at trial.
Independently handle cases as a lead investigator, which are characterized by obscure leads, few visible records, uncooperative witnesses, and conflicting evidence.
Develop an understanding of all applicable federal, state, or local laws to the extent necessary to make sound decisions on the direction and scope of investigations.
Examine books, ledgers, payrolls, cost reports, billing transactions, events, or allegations under investigation.
Prepare interim and final reports on progress of investigations for use by attorneys.
Responsibilities will increase and assignments will become more complex as your training and experience progress.
Requirements Conditions of Employment You must be a United States Citizen or National.
Initial appointment is conditioned upon a satisfactory pre-employment adjudication.
This includes fingerprint, credit and tax checks, and drug testing.
Continued employment is subject to a favorable adjudication of a background investigation You must be registered for Selective Service, if applicable.
If selected, you may be required to complete a one year probationary period.
You must meet all qualification requirements upon the closing date of this announcement.
Qualifications GS-11: To be eligible at the GS-11 level, you must have at least one year of specialized experience equivalent to the GS-9 level; or education or a combination of both specialized experience and education as explained below.
Specialized experience is defined as experience conducting routine investigations and/or financial examinations as the lead or sole investigator or analyst, or assisting with complex investigations as an investigator or analyst; knowledge of relevant state, local, and/or federal laws or regulations regarding health care fraud, contracting fraud, or other fraud; conducting interviews of witnesses; creating reports on the progress of investigations for use by attorneys; and identifying significant findings and conclusions, recommendations for additional investigative actions, and candid assessments of strengths and weaknesses of witnesses, documentary evidence, or other aspects of cases.
Education: One of the following types of education in a related field (e.
g.
, Criminal Justice): a Ph.
D.
or equivalent doctorate degree; OR 3 full years of progressively higher level graduate education leading to such a degree.
Education at the graduate level must be in an accredited college or university and must demonstrate the knowledge, skills, and abilities necessary to perform the duties of the position.
Combining Education and Experience: Combinations of successfully completed graduate education and experience may be used to meet total qualification requirements.
In order to qualify based on a combination, graduate education must be in excess of 2 full years.
Interagency Career Transition Assistance Plan (ICTAP)- The ICTAP provides eligible displaced Federal competitive service employees with selection priority over other candidates for competitive service vacancies.
If your agency has notified you in writing that you are a displaced employee eligible for ICTAP consideration, you may receive selection priority if: 1) this vacancy is within your ICTAP eligibility; 2) you apply under the instructions in the announcement; and 3) you are found well-qualified for this vacancy.
To be well-qualified, you must satisfy all qualification requirements for the vacant position and receive a score of 85 or better on established ranking criteria.
You must provide proof of eligibility to receive selection priority.
Such proof may include a copy of your written notification of ICTAP eligibility or a copy of your separation personnel action form.
Additional information about ICTAP eligibility is at: https://www.
opm.
gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ Career Transition Assistance Plan (CTAP)-The CTAP provides eligible surplus and displaced competitive service employees in the Department of Justice with selection priority over other candidates for competitive service vacancies.
If your Department of Justice component has notified you in writing that you are a surplus or displaced employee eligible for CTAP consideration, you may receive selection priority if: 1) this vacancy is within your CTAP eligibility, 2) you apply under the instructions in this announcement, and 3) you are found well-qualified for this vacancy.
To be well qualified, you must satisfy all qualification requirements for the vacant position and receive a score of 85 or better on established ranking criteria.
You must provide a copy of your written notification of CTAP eligibility with your application.
Additional information about CTAP eligibility is at: https://www.
opm.
gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ Education All academic degrees and coursework must be completed at a college or university that has obtained accreditation or pre-accreditation status from an accrediting body recognized by the U.
S.
Department of Education.
For a list of schools that meet this criteria, see www.
ed.
gov.
OR Education completed in foreign colleges or universities may be used to meet the above education requirements if you can show that the foreign education is comparable to that received in an accredited educational institution in the United States.
It is your responsibility to timely provide such evidence by submitting proof of creditability of education as evaluated by a credentialing agency with your application materials.
More information may be found at www2.
ed.
gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.
html.
All documentation must be in English or include an English translation.
Additional information Payment of relocation expenses will not be authorized.
The Department of Justice offers a comprehensive benefits package that includes, in part, paid vacation; sick leave; holidays; telework; life insurance; health benefits; and participation in the Federal Employees Retirement System.
Veterans' Preference - If you are entitled to Veterans' Preference, you must indicate the type of preference you are claiming by checking the appropriate box in the assessment questionnaire to indicate your preference and submit the required veterans' preference documentation as specified in the, "Required Documents" section of this vacancy announcement.
Selective Service: If you are a male applicant born after December 31, 1959, you must certify that you have registered with the Selective Service System, or are exempt from having to do so under the Selective Service Law.
See www.
sss.
gov Reasonable Accommodation Statement: Federal Agencies must provide reasonable accommodation to applicants with disabilities, where appropriate.
Applicants requiring reasonable accommodation for any part of the application and hiring process should contact the hiring agency directly.
Determinations on requests for reasonable accommodation will be made on a case-by-case basis.
EEO Statement: The United States Government does not discriminate in employment on the basis of race, color, religion, sex, national origin, political affiliation, sexual orientation, marital status, status as a parent, genetic information, disability, age, membership or non-membership in an employee organization, or on the basis of personal favoritism.
Diversity Statement: As the federal agency whose mission is to ensure the fair and impartial administration of justice for all Americans, the Department of Justice is committed to fostering a diverse and inclusive work environment.
To build and retain a workforce that reflects the diverse experiences and perspectives of the American people, we welcome applicants from the many communities, identities, races, ethnicities, backgrounds, abilities, religions, and cultures of the United States who share our commitment to public service.
Benefits A career with the U.
S.
government provides employees with a comprehensive benefits package.
As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding.
Opens in a new windowLearn more about federal benefits.
Review our benefits Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent.
Contact the hiring agency for more information on the specific benefits offered.
How You Will Be Evaluated You will be evaluated for this job based on how well you meet the qualifications above.
Your application will be evaluated and rated under DOJ's Category Rating and Selection Procedures.
Your resume and supporting documentation will be used to determine whether you meet the job qualifications listed on this announcement.
If you are basically qualified for this job, your resume and supporting documentation will be compared to your responses on the Occupational Questionnaire.
If you rate yourself higher than is supported by your application materials, your responses may be adjusted and/or you may be excluded from consideration for this job.
If it is determined you meet minimum qualification requirements, your application will then be placed in one of three categories: Best Qualified, Highly Qualified, or Qualified.
Within these categories, applicants eligible for Veterans' Preference will receive selection priority over non-veteran preference eligibles.
In addition, qualified veterans with a compensable service-connected disability of 10% or more are placed at the top of the highest quality category (i.
e.
, Best Qualified).
You will be rated on the following Competencies (see OPM Website for definitions): Attention to Detail, Oral Communication, Planning and Evaluating, and Reasoning.
The Occupational Questionnaire will take you approximately 20 minutes to complete.
Benefits A career with the U.
S.
government provides employees with a comprehensive benefits package.
As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding.
Opens in a new windowLearn more about federal benefits.
Review our benefits Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent.
Contact the hiring agency for more information on the specific benefits offered.
Required Documents As a new or existing federal employee, you and your family may have access to a range of benefits.
Your benefits depend on the type of position you have - whether you're a permanent, part-time, temporary or an intermittent employee.
You may be eligible for the following benefits, however, check with your agency to make sure you're eligible under their policies.
You must provide a complete Application Package which includes: - Required: Your responses to the Online Occupational Questionnaire (This is completed automatically during the apply online process).
- Required: Your resume showing relevant experience and dates (for full consideration you must include day/month/year) of employment and work schedule for each (e.
g.
, part-time XX hours per week or full-time) (cover letter optional).
).
Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.
g.
, Peace Corps, AmeriCorps) and other organizations (e.
g.
, professional; philanthropic; religious; spiritual; community, student, social).
Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment.
You will receive credit for all qualifying experience, including volunteer experience.
- Required if you meet qualifications based on education: An unofficial college transcript.
(Note: If you are selected for this position, official transcript will be required prior to your first day.
) and foreign education evaluation documentation, if applicable, as described under the "Education" section of this vacancy announcement.
-Required, if applicable: CTAP/ICTAP documentation (a copy of a separation notice or other proof of eligibility for priority selection; a copy of an SF-50, Notification of Personnel Action, showing current position, grade, promotion potential, and duty location; AND a copy of your most recent performance appraisal.
) - Required, if applicable: Veterans' Preference documentation.
See Required Veterans' Preference Documentation below.
Please note, if you are entitled to Veterans' Preference, you must indicate the type of preference you are claiming in your application, check the appropriate box in the assessment questionnaire to indicate your preference, and submit the required documentation as specified below.
Required Veterans' Preference Documentation: -In order to verify your Veterans' Preference entitlement, you must submit a copy of the Member Copy 4 of your DD-214 (Certificate of Release or Discharge from Active Duty); or if you are a current Active Duty member you must submit a certification on appropriate military branch letterhead that indicates: 1) your service dates, 2) expected discharge or release date from active duty with a release/discharge date no later than 120 days from the closing date of this announcement, and 3) the character of service (e.
g.
, Honorable); or other official documentation (e.
g.
, documentation of receipt of a campaign badge or expeditionary medal) that shows your military service was performed under honorable conditions.
In addition, if you are a disabled veteran, a Purple Heart recipient, or widow/widower if a veteran, the spouse of a disabled veteran or the parent of a disabled or deceased veteran, you must submit a Standard Form (SF) 15, "Application for 10-Point Veteran Preference" dated October 2013 and all the required documentation identified on the reverse side of the SF-15 to support your preference claim.
If you are relying on your education to meet qualification requirements: Education must be accredited by an accrediting institution recognized by the U.
S.
Department of Education in order for it to be credited towards qualifications.
Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.
S.
Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
How to Apply To apply for this position, you must complete the occupational questionnaire and submit the documentation specified in the Required Documents section below.
1.
To begin, click Apply Online to create a USAJOBS account or log in to your existing account.
Follow the prompts to select your USAJOBS resume and/or other supporting documents and complete the occupational questionnaire.
2.
Click the Submit My Answers button to submit your application package.
(It is your responsibility to ensure your responses and appropriate documentation are submitted prior to the closing date.
) 3.
To verify your application is complete, log into your USAJOBS account, my.
usajobs.
gov/Account/Login, select the Application Status link and then select the more information link for this position.
The Details page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application.
Your uploaded documents may take several hours to clear the virus scan process.
To return to an incomplete application, log into your USAJOBS account and click Update Application in the vacancy announcement.
You must re-select your resume and/or other documents from your USAJOBS account or your application will be incomplete.
To preview the Assessment Questionnaire, please click the following link: https://apply.
usastaffing.
gov/ViewQuestionnaire/12196940 You are encouraged to apply online.
Applying online will allow you to review and track the status of your application.
If you are unable to apply online, contact Cynthia Pittman at Cynthia.
Pittman@usdoj.
gov or (601) 965-4480 as soon as possible to arrange an alternative application process.
The complete application package must be submitted by 11:59 PM (ET) on 12/29/2023 to receive consideration.
Keep a copy of your proof of submission in the event verification is needed.
Current or Former Political Appointees: The Office of Personnel Management (OPM) must authorize employment offers made to current or former political appointees.
If you are currently, or have been within the last 5 years, a political Schedule A, Schedule C or Non-Career SES employee in the Executive Branch, you must disclose this information to the HR Office.
Failure to disclose this information could result in disciplinary action including removal from Federal Service.
Agency contact information Cynthia Pittman Phone (601) 965-4480 Fax (601) 965-5680 Email Cynthia.
Pittman@usdoj.
gov Address Southern District of Mississippi 501 East Court Street Jackson, MS 39201 US Next steps We will notify you of the outcome after each step of the recruitment process has been completed.
After making a tentative job offer, we will conduct a suitability/security background investigation, to include a credit check, and drug test by urinalysis.
We expect to make a final job offer within 80 days after the closing date of the announcement.
Fair and Transparent The Federal hiring process is set up to be fair and transparent.
Please read the following guidance.
Equal Employment Opportunity (EEO) Policy Reasonable accommodation policy Financial suitability Selective Service New employee probationary period Signature and false statements Privacy Act Social security number request Required Documents You must provide a complete Application Package which includes: - Required: Your responses to the Online Occupational Questionnaire (This is completed automatically during the apply online process).
- Required: Your resume showing relevant experience and dates (for full consideration you must include day/month/year) of employment and work schedule for each (e.
g.
, part-time XX hours per week or full-time) (cover letter optional).
).
Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.
g.
, Peace Corps, AmeriCorps) and other organizations (e.
g.
, professional; philanthropic; religious; spiritual; community, student, social).
Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment.
You will receive credit for all qualifying experience, including volunteer experience.
- Required if you meet qualifications based on education: An unofficial college transcript.
(Note: If you are selected for this position, official transcript will be required prior to your first day.
) and foreign education evaluation documentation, if applicable, as described under the "Education" section of this vacancy announcement.
-Required, if applicable: CTAP/ICTAP documentation (a copy of a separation notice or other proof of eligibility for priority selection; a copy of an SF-50, Notification of Personnel Action, showing current position, grade, promotion potential, and duty location; AND a copy of your most recent performance appraisal.
) - Required, if applicable: Veterans' Preference documentation.
See Required Veterans' Preference Documentation below.
Please note, if you are entitled to Veterans' Preference, you must indicate the type of preference you are claiming in your application, check the appropriate box in the assessment questionnaire to indicate your preference, and submit the required documentation as specified below.
Required Veterans' Preference Documentation: -In order to verify your Veterans' Preference entitlement, you must submit a copy of the Member Copy 4 of your DD-214 (Certificate of Release or Discharge from Active Duty); or if you are a current Active Duty member you must submit a certification on appropriate military branch letterhead that indicates: 1) your service dates, 2) expected discharge or release date from active duty with a release/discharge date no later than 120 days from the closing date of this announcement, and 3) the character of service (e.
g.
, Honorable); or other official documentation (e.
g.
, documentation of receipt of a campaign badge or expeditionary medal) that shows your military service was performed under honorable conditions.
In addition, if you are a disabled veteran, a Purple Heart recipient, or widow/widower if a veteran, the spouse of a disabled veteran or the parent of a disabled or deceased veteran, you must submit a Standard Form (SF) 15, "Application for 10-Point Veteran Preference" dated October 2013 and all the required documentation identified on the reverse side of the SF-15 to support your preference claim.
If you are relying on your education to meet qualification requirements: Education must be accredited by an accrediting institution recognized by the U.
S.
Department of Education in order for it to be credited towards qualifications.
Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.
S.
Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
Help This job is open to The public U.
S.
Citizens, Nationals or those who owe allegiance to the U.
S.
Clarification from the agency All U.
S.
Citizens and Nationals