Insurance Investigator Jobs in Oregon (NOW HIRING)

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The Oregon Department of Justice (DOJ) - Civil Enforcement Division is seeking an Investigator 3 interested in joining our team. Our employees are currently working hybrid work schedules as business needs allow. The candidate selected for this position will do the same.

Health care fraud enforcement is a national priority. The Medicaid Fraud Unit of our Civil Enforcement Division investigates and prosecutes fraud by Medicaid providers and allegations of abuse/neglect and financial exploitation of residents in long term care facilities. If selected, you will join DOJ as part of a dynamic, high-achieving, multi-disciplinary team charged with investigating and prosecuting health care fraud state-wide.

DUTIES AND RESPONSIBILITIES (in part)

• Collect, evaluate, and analyze computerized data and other evidence (e.g., medical records, Medicaid claims data, and social service, financial, records and legal records).

• Interview witnesses and suspects (including health care professionals, Medicaid agency personnel and Medicaid recipients).

• Draft accurate, detailed reports of investigative findings and interview reports.

• Prepare graphs, charts, reports etc. for presentations.

• Process referrals, conduct preliminary screenings, and make recommendations.

• Research Medicaid policies and programs.

• Testify in grand juries, hearings, and trials.

• Coordinate with social service agencies and local/state/federal law enforcement entities.

REQUIRED ATTRIBUTES AND SPECIAL REQUIREMENTS

Research suggests that women and people of color are less likely to apply unless they are confident they meet 100% of the listed qualifications. We strongly encourage all interested individuals to apply, and allow us to evaluate the knowledge, skills, and abilities that you demonstrate, using an intentional equity lens.

In order to be considered for this position, you must meet ALL the following minimum qualifications:

• Four years of recent (within last ten years) full-time investigative experiencewhichincluded: 1.) conducting fact finding; 2.) collecting and preserving evidence according to the rules of evidence; 3.) examining records; 4.) locating and interviewing witnesses to verify or disprove claims of suspected law violations; 5.) and writing investigation reports sufficient for use at administrative hearings or in court. Examples of qualifying investigation experience are in areas such as law enforcement investigation, insurance investigation, investigative trial support, or financial fraud investigation. College-level courses in Law Enforcement, Criminal Justice, Law, Accounting, or Auditing may be substituted on a year-for-year basis for up to one year of the required experience.

• Have and be able to maintain an Oregon State driver license, throughout employment; willing and able to travel as needed (i.e., investigations, court dates, meetings, trainings, etc.).

DESIRED SKILLS AND ATTRIBUTES

• Possess excellent analytical, communication, and organizational skills.

• Healthcare related background.

• Experience interviewing witnesses and suspects, who are occasionally uncooperative and hostile.

• Experience writing interview and investigative reports

• Experience testifying in administrative, civil, or criminal proceedings.

• Experience working as part of a multidisciplinary team.

• Experience reviewing and analyzing financial records.

• Expert-level in Microsoft Excel, and experience reviewing and analyzing data a plus!

WHAT'S IN IT FOR YOU

• Work/life balance to include 11 paid holidays a year, vacation, sick leave, personal business leave, and a competitive benefits package.

• Permanent, full-time employment in Portland, Oregon.

• A workplace where individual contribution matters and is recognized; and where creativity and accomplishment are rewarded.

• Opportunity to expand your government auditing and data analysis skills.

• Excellent medical, dental, and vision benefits.

• Pension and retirement programs.

• Endless peer and management support, and representation by the Service Employees International Union (SEIU).

For more information about our benefits, you can learn here.

APPLICATION PROCESS

We strongly encourage all interested individuals to apply, and allow us to evaluate the knowledge, skills and abilities that you demonstrate, using an intentional equity lens. Candidates from diverse backgrounds are encouraged to apply. The Department of Justice is an equal opportunity employer, does not discriminate based on race, color, national origin, ethnicity, veteran, gender, sexual orientation, religion, age, or disability, and is committed to workplace diversity.

• Click "Apply" and complete the online application and all supplemental questions.

• Attach your resume.

• Attach your cover letter (1-2 pages), specifically addressing how you meet the qualifications for this position.

ALL APPLICANTS: You will only have one opportunity to upload the required resume and cover letter. Drag and drop your resume and cover letter into Workday when prompted to upload. If you are concerned that one or both required documents didn't attach to your application, if you need an accommodation under the Americans with Disabilities Act (ADA), have questions, or need assistance with the application process, please contact doj.recruitment@doj.oregon.gov. Any materials emailed will be associated on your behalf if received before the posting deadline.

CURRENT STATE EMPLOYEES: Login to Workday using your state-issued login and apply via the Jobs Hub Worklet located on your home page. Using a private account disrupts the hiring process for all internal candidates. Prior to clicking "Apply", update your employee profile to reflect your Education, Skills, and Job History (including your current job).

For additional information regarding working for the Department of Justice and application assistance, click HERE.

Oregon Department of Justice
1162 Court St NE
Salem OR, 97301
DOJ.recruitment@doj.oregon.gov

Phone: (503) 947-4328
Fax: (503) 373-0367