The Oregon Department of Justice is recruiting for the position of Government Auditor 3 with the Civil Enforcement Division, Medicaid Fraud Unit located in Portland, Oregon. There is a current full-time vacancy located in Portland.  This recruitment will be used to establish a list of qualified applicants and will be used to fill the current vacancy only.

The Governor has ordered mandatory furloughs to be taken by all employees during the 2009-2011 biennium due to the economic downturn and subsequent state budget short-fall.  The total number of unpaid furlough days to be taken during the biennium is determined by the employee's monthly salary and date of hire. Because of this, the advertised salary does not reflect the impact of furlough days required of this position.   However, the impact of one furlough day on one's monthly salary should not exceed 5%.  

Applicants will be subject to a computerized Criminal History and Driver and Motor Vehicle Services check as well as a thorough background investigation.   Adverse background data may be grounds for immediate disqualification.

H.I.R.E. System participants interested in being considered for this position must follow the TO APPLY instruction listed in this announcement.

GENERAL INFORMATION

This position is with the state’s Medicaid Fraud Unit (MFU) which is responsible for the statewide investigation and prosecution of allegations of fraudulent billing by Medicaid providers against the Medicaid Program; allegations of physical, sexual or financial abuse/neglect of individuals residing in long-term care facilities committed by staff of the facility; allegations of misappropriation of funds occurring in Medicaid funded businesses or facilities; and allegations of fraud in the administration of the Medicaid Program.  Cases may be pursued as part of a multi-disciplinary task force made up of staff from the MFU, the FBI, the Office of Inspector General for the US Department of Health and Human Services, and the US Attorney’s Office/US Department of Justice.

This position plans, organizes and directs comprehensive financial audits and investigations of programs, businesses, offices and companies which provide goods and services paid for with state/federal health care dollars, as necessary for the criminal and, in limited cases, civil prosecution of cases within the Unit’s authority.  These audits and investigations are often highly sensitive in nature, large scale and complex, and frequently involve coordinating and leading teams of individuals from other state and federal law enforcement entities.

PRINCIPAL DUTIES AND RESPONSIBILITIES

• Review referrals; procure evidence; analyze and interpret computerized data, financial records, billing records, legal documents and other material in the pursuit of evidence. Coordinate with other law enforcement entities. Identify and interview suspects, witnesses, health care professionals, Medicaid personnel and recipients, etc. Ensure all physical and documentary evidence is obtai8ned and secured. Determine if other professional services (handwriting analysis, polygraph, expert medical witness) are necessary and procure that assistance. Determine through legally supportable means damage figures, including building data bases for alternative theories of liability as appropriate. Develop accurate detailed reports of investigative findings describing policy, financial, medical and legal aspects of cases; including recommendations with appropriate justification for criminal prosecution or appropriate civil or administrative action. Obtain evidence of Oregon damages for support of multi-state or national cases being pursued under the Federal False Claims Act.
• Assist attorney in formulating presentment of case, identification of witnesses and drafting of pleadings/charges. Provide input in formulating plea bargain or settlement proposals; participate in pre-admissible charts/graphs for use as evidence. Assist MFU attorney or US Attorney/prosecutor in jury selection and presentation of case at trial, including admission of massive amounts of documentary evidence. Testify and be subject to cross-examination at deposition and trial.
• Respond to requests from federal or state/local agencies for advice and support in health care related matters, including cost report reviews, program audits, computer searches; etc. on request, review work of those agencies and help formulate plans/procedures for audit, investigation/review.
• Participate in MFU “on call rotation” to talk to callers/visitors regarding potential referrals. Formulate reports/memorandum and any recommended actions on referrals taken while on call. Participate in weekly case screening meetings and other meetings to discuss MFU policies and procedures. assist MFU staff in devising and implementing programs, policies and procedures to detect, prosecute or prevent fraud/abuse by Medicaid Providers, including development of proactive projects to review billing records to identify potential fraud cases. Contribute to formulating and developing MFU procedures to respond to increasingly sophisticated technological demands. Assist attorneys in preparing/presenting training programs on health care fraud or elder/dependent abuse/neglect.

Your State of Oregon application form (PD 100) will be reviewed to verify that you meet the minimum qualifications stated in this section.  To receive credit, your application form must clearly show that you have:

• a Bachelor's degree in a business-related field, such as business administration, public administration, finance, economics, computer science, etc.,  AND three years of auditing experience that includes one year of experience doing governmental auditing.

• Twenty quarter hours of college courses in a business or financial field such as the areas listed above AND two additional years of auditing experience may substitute for the degree.

• Successful completion of the duties and training as an Oregon Governmental Auditor (Entry) will substitute for one year of governmental auditing experience.

A copy of your transcripts must be submitted for all required or related courses.

IF YOU QUALIFY, SEE TEST section of this announcement.

Review referrals to the Unit for appropriate handling.  Procure evidence utilizing most appropriate means, analyze and interpret computerized data, financial records, billing records, legal documents and other material in the pursuit of evidence.  Identify and interview suspects and witnesses, health care professionals, Medicaid personnel and recipients. Ensure all evidence is obtained and secured in compliance with state and federal evidentiary rules and rules of criminal procedure.  Determine damage figures, including building databases for alternative theories of liability.  Develop accurate and detailed reports of findings describing policy, financial, medical and legal aspects of case including recommendations for criminal prosecution or appropriate civil or administrative action. 

Assist Assistant Attorney General in development of case for prosecution including drafting of pleading/charges; identifying witnesses; and preparation of evidence in an understandable manner.  Participate in preparation of plea bargain or settlement proposals, participate in conferences and hearings regarding these issues.  Testify and be subject to cross-examination at deposition and trial.

Respond to requests from federal, local or other state agencies for advice and assistance in health care related matters.   As requested, review work of those agencies and help formulate plans for audits, investigations or reviews.
 

Exposure to noise from ringing telephones, printers, copiers, telephone conversations and other office equipment;

Daily use of personal computers;

Significant time spent daily examining and analyzing complex financial records, medical records, billing records, and computer records;

Daily juggling of multiple tasks with varying Intermittent demands to work overtime, weekends and evenings;

Frequent contact with uncooperative and potentially hostile defendants and witnesses;

Frequent in-state driving and traveling, occasional out-of-state travel;

YOU MUST ANSWER THE FOLLOWING QUESTION:

FOLLOW THESE INSTRUCTIONS CAREFULLY.  Your application will not be accepted if your answers to the following questions are incomplete. Use a separate sheet of paper.  Write down any work experience (paid or unpaid) and training that you have which is related to each question.  Limit your answer to no more than two (2) pages. Be sure that the jobs where you gained the experience you describe in your answers are listed in the Work History section of your application form.  Your grade will be based on your answers. If there are several parts to a question, answer each part separately.  Number your answers to agree with the question.  Attach the answer sheet to your application.

1. The person in this position performs audits that are used as the basis for criminal or civil fraud prosecutions. Please describe your experience as an auditor. What types of businesses/programs have you audited? What was your level of responsibility for the audits? What types of reports did you have to generate? What types of audits did you perform (forensic, financial, compliance)? Describe your experience with forensic audits. What experience have you had with audits involving alleged health care fraud and with alleged financial fraud or embezzlement? Have you ever had to recreate missing accounting records from collateral information? If so, how did you go about doing that? What is your experience in tracing expenditures/transactions back to a particular business, individual or source of funds?
2. The person in this position will be required to conduct interviews of suspects, victims and witnesses. Describe your experience conducting interviews of suspects, victims and/or witnesses. What was the purpose of the interviews? Have you ever participated in interviews of suspects, victims or witnesses as part of a civil or criminal fraud investigation? Who else was generally present at these interviews? Did you have to write reports of your interviews?
3. The person in this position will be called upon to testify before grand juries and in court proceedings. Describe your experience providing testimony in a court or hearing situation. What types of cases were involved? Was this part of your official work duties? Were you qualified as an expert? Did any of these situations involve potential forfeiture of assets?

HOW TO APPLY

Complete and submit a State of Oregon Employment application (form PD100) and any required supplements.  Copies of applications, supplements and job announcements can be obtained from:

1. the State’s Jobs Page at: www.oregonjobs.org
2. local Oregon Employment Department field offices
3. most state agency personnel offices.

If you have a disability and need an alternate format in order to complete the application process, you may call the Department of Justice at (503) 378-5555, or TTY (800) 735-1232 for the hearing impaired.  Please be prepared to leave a message describing the alternate format needed.

Mail, deliver or fax the complete application materials to:

Oregon Department of Justice

Human Resources Section

1162 Court St. NE

Salem, OR   97301-4096

FAX (503) 373-0367 

Your application must arrive by 5:00 pm on the close date and must be complete and legible.  We are unable to acknowledge or verify receipt of applications due to the large volume.

Please be sure to complete all parts of the application.  If your application is incomplete, or does not clearly show the experience and/or training required, you will receive a notice by mail advising you why your application was not accepted.

NOTICE of results will be sent by mail.  Although we are not required to delay our selection process, you may request a review of the results.  Your request must be received within 10 days from the date of the notice.  Additional information cannot be accepted.  However, if the recruitment is still open, you may submit a new application, which must be received in our office by the close date.

SUBMIT only the required materials.  Reference letters or work examples should be kept for interviews.

KEEP a copy of your application for job interviews.  COPIES ARE NOT PROVIDED.

The pay on all announcements may change without notice.

OREGON DEPARTMENT OF JUSTICE IS AN EQUAL OPPORTUNITY,

AFFIRMATIVE ACTION EMPLOYER COMMITTED TO WORK FORCE DIVERSITY