Nurse Investigator

RHODE ISLAND OFFICE OF THE ATTORNEY GENERAL
NURSE INVESTIGATOR
MEDICAID FRAUD CONTROL AND PATIENT ABUSE UNIT
CRIMINAL DIVISION
PAY GRADE: 8728 ($70,644 – $79,893)
September 1, 2023 – September 22, 2023
About the Office: The Attorney General is the state’s top lawyer and law enforcement official, protecting and serving the people and interests of Rhode Island through a broad range of duties. Every day, the Office’s attorneys fight to ensure the public safety of the state’s communities, improve the economic security of its citizens, safeguard the state’s spectacular natural resources, and restore the public’s trust in government. Assistant and Special Assistant Attorneys General represent the people of Rhode Island in civil and criminal matters before trial courts, appellate courts, and the Supreme Court of Rhode Island and the United States. The Office is unique among attorneys general offices across the country. Out of fifty states, only two other offices share the same broad criminal mission. The Office’s attorneys prosecute complex and violent crimes and functionally serve as one of the nation’s largest district attorney’s offices, prosecuting all felonies throughout the state.
About the Medicaid Fraud Control and Patient Abuse Unit: The MFCU investigates and prosecutes Medicaid provider fraud, patient abuse/neglect, and prescription drug diversion. The MFCU has authority to hold individuals or entities accountable through criminal prosecution and/or civil litigation. The Unit also makes recommendations to the U.S. Department of Health and Human Services, Office of the Inspector General to exclude individuals or entities from participating in federally funded programs.
Primary Duties: The successful candidate will provide support to a staff of criminal investigators, an auditor, and prosecutors in the Medicaid Fraud Control Unit. Responsibilities include review and analysis of medical records, complaints against providers, reports of abuse and neglect, and reviewing Medicaid claims data. Additional responsibilities include interviewing victims, witnesses, and targets; collecting and securing evidence; writing interview reports and investigative memoranda; conducting research related to medical standards of care; reviews, analyzes, interprets and prepares detailed summaries of medical records, charts, medication administration records, Minimum Data Set resident assessment instruments, ICD-10/CPT coding, and Medicaid claims/utilization data, assists in interpretation and application of rules and regulations pertaining to health care services and claims for reimbursement of same,
assisting Special Assistant Attorneys General in case preparation, identification, recruiting, and preparation of medical experts, testifying at grand jury and trial, provide training and outreach
presentations to health care facilities, regulatory boards, and the public, and completing other investigative tasks, as necessary.
If applying for position by submitting cover letter and resume via mail or email, no need to apply through online system.
How to Apply: Applicants should email or mail (1) a cover letter summarizing why you are interested and describing the skills and abilities you possess that will enable you to succeed in this position, (2) resume, and (3) list of three references to:
Aida Crosson
Director of Administration
Office of the Attorney General
150 South Main Street, Providence, RI 02903
[email protected]
Equal Opportunity Employer: The Attorney General’s Office is stronger, more credible, and more capable when its employees bring diverse backgrounds, cultures, and perspectives to their work. The Office encourages all qualified applicants from all ethnic and racial backgrounds, veterans, LGBTQ individuals, and persons with disabilities to apply.
All qualified applicants will receive consideration without regard to race, color, sex, religion, sexual orientation, gender identity or expression, age, national origin, disability, or covered veteran status.
Other Information: Finalists will be subject to a background investigation including reference checks. All offers of employment are contingent upon successful completion of the background investigation.