Connecticut StateDepartment of Administrative Services

Forensic Fraud Examiner

Recruitment #210601-4605AR-001

Introduction



Are you detail oriented and looking to make a difference in your state? If so, then we are looking for you to join our team!

WHO WE ARE:
The State of Connecticut, Department of Social Services (DSS) delivers and funds a wide range of programs and services as Connecticut’s multi-faceted health and human services agency. DSS serves about 1 million residents of all ages in all 169 Connecticut cities and towns. We support the basic needs of children, families, older and other adults, including persons with disabilities. Services are delivered through 12 field offices, central administration, online and phone access options. Follow us on twitter @ctdss and see what we are all about!

THE ROLE:
In this position, the Forensic Fraud Examiner investigates potential fraudulent activities by providers enrolled in the Connecticut Medical Assistance Program (CMAP). This position is vital to the continued performance of Special Investigations Unit. This position is located at the Office of Quality Assurance, Special Investigation Division, 55 Farmington Avenue, Hartford, CT. This full time position (40 hours per week) has a work schedule of Monday - Friday, 8:00 am - 4:30 pm.

Discover the opportunity to:
  • Develop detailed fraud referral reports
  • Work closely with the Office of the Attorney General, The Medicaid Fraud Control Unit, and the Department of Health and Human Services (HHS), Office of Investigations. Once a fraud referral is made, the FFE 
  • Provide ongoing support to the investigating agencies The FFE
  • Investigate complaints made to DSS and evaluate for possible agency action using various resources
We hope you pursue joining our team and encourage you to detail your related experience on the application!

Selection Plan

In order to be considered for this job opening, you must be a current State of CT employee, who has permanent state status* and meet the Minimum Qualifications as listed on the job opening.  You must specify your qualifications on your application.

*For employees in the classified service, permanent status is obtained after successful completion of a working test period.  For employees in the unclassified service, permanent status is obtained after serving in a position for at least six months (full-time or full-time equivalent).

Please Note: You will be unable to make revisions once you submit your application for this posting to the JobAps system.

This posting may require completion of additional referral questions (RQs) which will be sent to you via email after the closing date. The email notification will include an expiration date by which you must submit (Finish) your responses. Please regularly check your email for notifications. Please check your SPAM and/or Junk folders, as emails could end up there in error.

The minimum experience and training requirements must be met by the close date on the job opening, unless otherwise specified.

If selected for further consideration, State employees may be required to provide last 2 service ratings and last 2 attendance records.

The Department of Social Services participates in E-Verify.

The immediate vacancy is listed above, however applications to this recruitment may be used to fill future vacancies in the job classification.

Should you have questions pertaining to this recruitment, please contact Michelle Gara at Michelle.Gara@ct.gov.

PURPOSE OF JOB CLASS (NATURE OF WORK)

In the Office of the Attorney General and the Departments of Social Services, Revenue Services and Transportation, this class is accountable for conducting the most complex and difficult forensic examinations of financial records in matters under investigation by the agency and law enforcement authorities.

EXAMPLES OF DUTIES

Performs most complex forensic analysis of financial records related to complex financial fraud investigations undertaken by the agency; participates as a member of task forces on most complex cases; reviews referred complaints for existence of financial fraud; examines prior audit reports, financial statements, budgets or other available data for evidence of fraud, waste or abuse; examines accounting methods and procedures to insure compliance with accepted accounting practices; analyzes and traces proceeds of other assets involved in fraudulent schemes; identifies assets for possible seizure and/or forfeiture; utilizes intelligence databases for financial records, reports and forensic analysis in investigations; conducts interviews of witnesses and targets; provides technical assistance to staff; acts as a liaison with other operating units, agencies and outside officials regarding unit policies and procedures; participates in hearings and settlement negotiations; prepares reports and makes recommendations in investigations; testifies in administrative and other legal proceedings regarding forensic fraud analysis and audit results; performs related duties as required.

KNOWLEDGE, SKILL AND ABILITY

Considerable knowledge of and ability to apply professional accounting and auditing principles and practices; considerable knowledge of relevant industry accounting principles and practices; considerable knowledge of substance and application of relevant statutes and regulations; considerable knowledge of courtroom procedure; considerable knowledge of evidence; considerable knowledge of and ability to utilize EDP systems; considerable oral and written communication skills; interpersonal skills; considerable ability to analyze complex financial records, documents and reports for evidence of financial fraud; considerable ability to prepare comprehensive reports and exhibits.

MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE

Seven (7) years of experience in accounting, auditing or financial examinations.

MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE

Two (2) years of the General Experience must have been in conducting forensic financial examinations.

MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED

1. College training in accounting may be substituted for General Experience on the basis of fifteen (15) semester hours equalling one-half (1/2) year of experience to a maximum of four (4) years for a Bachelor’s degree.
2. A Master’s degree in accounting or certification as a Certified Public Accountant, Certified Internal Auditor or Certified Fraud Examiner may be substituted for one (1) additional year of the General Experience.

PREFERRED QUALIFICATIONS

  • Experience performing healthcare claims analysis
  • Experience performing healthcare fraud investigations

SPECIAL REQUIREMENTS

1. Incumbents in this class may be required to travel.
2. Incumbents in this class may be required to possess and retain a valid Motor Vehicle Operator’s license.

Conclusion

AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER

The State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities.







The State of Connecticut is an Affirmative Action/Equal Opportunity Employer and strongly encourages the application of women, minorities and persons with disabilities.