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Intern-Medicaid Fraud Control Unit

Intern: The West Virginia Attorney General’s Office seeks a part-time Intern for the Medicaid Fraud Control Unit (“MFCU”). IS A TEMPORARY POSITION, AND THE SUCCESSFUL APPLICANT(S) APPOINTED TO THIS POSITION WILL NOT RECEIVE OR ACCRUE ANY WEST VIRGINIA STATE GOVERNMENT EMPLOYMENT BENEFITS SUCH AS HEALTH INSURANCE, ANNUAL LEAVE, SICK LEAVE, OR RETIREMENT BENEFITS IN CONNECTION WITH THEIR SERVICE.
The MFCU is charged with investigating, prosecuting, and obtaining criminal and civil remedies against individuals and corporate entities responsible for improper or fraudulent Medicaid billing schemes as well as investigating and prosecuting allegations of abuse, neglect, and financial exploitation of residents in nursing homes and other residential healthcare facilities.
To fulfill these obligations, the MFCU works to identify and investigate fraud committed by hospitals, nursing homes, pharmacies, home health agencies, transportation providers, clinics, hospitals, doctors, dentists, nurses, and other Medicaid providers – as well as individuals, who, for their own financial benefit, interfere with quality healthcare or exploit Medicaid beneficiaries.
Qualified applicants must possess good judgment and experience demonstrating the following:
  • Successful prior completion of at least 60 semester credit hours with an average grade point average no less than 3.0, including the successful prior completion of at least 12 semester credit hours in disciplines that are directly germane to the MFCU’s operations, including but not limited to criminal justice, accounting, cyber security, statistics, data analysis, nursing, public health, medical coding, medical terminology, medical insurance and billing practices, human anatomy, physiology, and health care management;
  • Proficiency with Microsoft Office applications, including Word and Excel;
  • Knowledge of correct English, and clear and comprehensive writing abilities; and
  • A valid driver’s license.
Qualified applicants must also possess the ability to:
  • Utilize automated online systems to collect and/or verify information;
  • Analyze and evaluate facts, statements, and other information;
  • Draw logical conclusions and make appropriate recommendations;
  • Learn and apply complex rules and regulations;
  • Comply with established policies and procedures;
  • Understand, retain, and follow written and verbal rules, regulations, and directives;
  • Read, write and speak English at the level necessary for satisfactory job performance, including the ability to communicate clearly and concisely, both orally and in writing
  • Establish and maintain effective working relationships with other employees and the public; and
  • Manage and prioritize assigned caseload.
Preferred qualifications include demonstrated experience in law enforcement, criminal investigations, or forensic science. Prior demonstrated interest in pursuing a career in law enforcement, criminal investigations, or forensic science is also viewed favorably. Highly qualified applicants also will have knowledge of basic investigative techniques and procedures, medical coding, and/or legal processes (e.g. pre-trial, trial, sentencing, post-sentencing, and appellate proceedings).
Responsibilities will include, but not be limited to:
  • Providing assistance to Investigators, Auditors, and Attorneys in conducting sensitive and complex health care fraud investigations, as well as investigations of alleged patient abuse, neglect, and financial exploitation.
  • Locating missing witnesses, victims, and subjects utilizing various sources and procedures including computer databases, skip-tracing procedures, telephone calls, and other methods customarily used by law enforcement agencies;
  • Assisting with serving subpoenas and other legal documents to witnesses, victims, and subjects in connection with the MFCU’s investigations ;
  • Retrieving and maintaining current data in the MFCU’s computer system and case management system;
  • Maintaining complete and accurate logs and records of activities performed;
  • Writing reports and letters as necessary;
  • Communicating with victims, witnesses, and/or subjects to obtain and/or clarify information related to assigned matters, documenting and summarizing the relevant information gathered through such communications;
  • Researching, collecting, and preserving materials that may be used as evidence;
  • Complying with office policies and procedures; and
  • Performing other duties as needed.
Applicants must commit to providing at least twenty (20) hours of service per week in support of the MFCU’s operations for the duration of the internship

Please send your resume to jobs@wvago.gov with "MFCU Intern" in the subject line.​