Closing Date: 23rd April, 2024
Description:
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 (MID) 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 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. The 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 MID provides opportunities to career prosecutors for professional growth. The MID has three levels of prosecutors – MID Criminal Attorney III, Criminal Attorney IV and Criminal Attorney V.
MID Criminal Attorney IIIs are experienced prosecutors who work independently. They have at least three years of legal experience. Typically, prior to joining the MID, they have recently served as assistant district attorneys prosecuting felonies in North Carolina. At the MID, they mainly work State cases involving patient abuse, misappropriation of patient funds and provider fraud. Additionally, they may occasionally assist with a federal case. While prior North Carolina prosecution experience is preferred for this position, candidates are not expected to have experience specifically prosecuting health care fraud.
MID Criminal Attorney IVs are more experienced prosecutors who adroitly prosecute highly complex cases in both State and federal court. Typically, persons hired as Attorney IVs have significant experience prosecuting white collar crimes – often as an assistant district attorney. Each Attorney IV is expected to serve as a Special Assistant United States Attorney (SAUSA) with at least one of the United States Attorney's Offices (USAO) in North Carolina. They will spend a significant amount of their time working federal cases. The amount of loss involved in many of the federal health care fraud cases exceeds a million dollars. The Attorney IVs also prosecute in State court. Another significant responsibility of the Attorney IVs is to mentor and train junior counsel. The Attorney IVs also screen referrals and make recommendations to the Director as to which cases are viable.
MID Criminal Attorney Vs are the most advanced prosecutors. They have developed significant expertise in prosecuting health care fraud. They are assigned cases of the highest complexity and significance. They are experienced SAUSAs who may serve as lead counsel on federal cases. The Attorney Vs serve as liaisons between the MID and other agencies including the United States Attorney's Offices. They serve as leaders within the MID. They lead other attorneys in the development and prosecution of federal and state cases. The Attorney Vs direct training, development and outreach efforts. They make recommendations to the Director for program, regulatory and legal changes. The Attorney Vs help screen referrals and make recommendations to the Director as to which cases are viable, as well as actively engage with outside agencies to increase the quantity and quality of referrals.
This posting is for a Criminal Attorney III.
In addition to its attorneys, the MID is staffed by investigators, auditors, analysts, paralegals, administrative staff and a nurse investigator. Cases are investigated 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. The MID provides state and national training opportunities for its employees.
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 travel which may include overnight stays.
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.
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 effect
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