State of Connecticut Executive Branch

DCJ Nurse Investigator (5902CJ)

$46.97-$62.28 Hourly / $3,757.48-$4,981.73 BiWeekly /
$98,070.00-$130,023.00 Yearly

PURPOSE OF JOB CLASS (NATURE OF WORK)

In the Division of Criminal Justice this class is accountable for investigating patient and recipient abuse, neglect and financial exploitation, prescription drug diversion and assisting with prosecuting Medicaid provider fraud.

SUPERVISION RECEIVED

Receives general direction from the Deputy Chief State’s Attorney for Operations, the DCJ Supervisory Assistant State’s Attorney for the Medicaid Fraud Control Unit or other employee of higher grade.

EXAMPLES OF DUTIES

  • Reviews and analyzes medical records, complaints against providers, reports of abuse and neglect, and Medicaid claims data;  
  • Reviews and analyzes complex medical documentation; 
  • Reviews, analyzes, interprets, and prepares detailed summaries of medical records, charts, medication administration records, Resident Assessment Instrument/Minimum Data Set (RAI\MDS), and CPT coding;  
  • Reviews the provisions of care delivered by health care providers and evaluates the standards of care and the medical necessity; 
  • Participates in investigations as part of the interdisciplinary team, including assisting in interviewing victims and witnesses, writing interview reports and investigative memoranda; 
  • Conducts research related to medical standards of care; 
  • Serves as a resource for the Medicaid Fraud Control Unit staff by explaining medical terminology, medical procedures, expected standards of care, and differing responsibilities of health care providers;  
  • Assists attorneys in case preparations and testifies in court when necessary;  
  • Prepares and performs outreach presentations for other state and law enforcement agencies, long-term care staff and the public regarding the mission of the Medicaid Fraud Control Unit to increase awareness and potential referrals of abuse and neglect cases;  
  • Works closely with other state and federal agencies;  
  • Performs related duties as required.

KNOWLEDGE, SKILL AND ABILITY

  • Knowledge of state and federal rules and regulations related to health care and health care facilities;
  • Considerable
    • interpersonal skills;
    • oral and written communication skills.

MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE

Five (5) years of experience as a registered nurse in a position involving nursing administration, abuse or neglect cases, consultation, or law enforcement.

MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED

  • A Bachelor's degree in nursing may be substituted for one (1) year of the General Experience.
  • A Master's degree in nursing may be substituted for one (1) additional year of the General Experience. 

SPECIAL REQUIREMENTS

  • Incumbents in this class must possess and retain a current license as a registered professional nurse in Connecticut.
  • Incumbents in this class must possess and retain a valid Motor Vehicle Operator’s license.
  • Incumbents in this class may be required to travel. 

JOB CLASS DESIGNATION

Unclassified

OCCUPATIONAL GROUP

(22)-NURSING

BARGAINING UNIT

(53)-DCJ NON-MANAGER EXMP

EEO

(2)-Professional

SALARY INFORMATION

CJ 29

ACKNOWLEDGEMENT

As defined by Sec. 5-196 of the Connecticut General Statutes, a job class is a position or group of positions that share general characteristics and are categorized under a single title for administrative purposes. As such, a job class is not meant to be all-inclusive of every task and/or responsibility.

CANCELLATION CLAUSE

New class. Item No. 23-188

EFFECTIVE DATE

09/21/2023
CLASS: 5902CJ; EST: 9/21/2023; REV: 9/22/2023;