At the State of Connecticut, Department of Social Services (DSS), we are currently looking for one qualified individual to join our newly created specialized Personal Care Attendant (PCA) Investigations Unit within the Special Investigations Division as a Forensic Fraud Examiner. This is an exciting opportunity to join the newly created specialized PCA Investigations Unit within the Special Investigations Division!
Position Highlights:
- 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 Hybrid work schedule of Monday - Friday, 8:00 am - 4:30 pm.
Your Role as a Forensic Fraud Examiner
In this position, the Forensic Fraud Examiner will investigate potentially fraudulent activities of PCA and Homemaker agencies enrolled in the Connecticut Medical Assistance Program (CMAP) and other HCBS services. This position will be accountable for acting as a working supervisor and policy specialist for this unit. This position is vital to the continued performance of the Special Investigations Division.
What We Can Offer You:
- Visit our new State Employee Benefits Overview page!
- The opportunity to work for a Forbes top company: 'Forbes' State of Connecticut Ranked One of the Best Employers of 2023 - State of CT Receives National Recognition for Offering Job Growth, Competitive Benefits, and Flexible Schedule
- Professional growth and development opportunities
- A healthy work/life balance to all employees
Discover the opportunity to:
- Investigate complaints made to DSS and evaluate possible agency action using various resources
- 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.
- Provide ongoing support to the investigating agencies
The Special Investigations Division is comprised of the following units:
The Provider Investigations Unit, which is charged with the responsibility of coordinating and conducting activities to investigate allegations of fraud in the Connecticut Medical Assistance Program. When appropriate, credible allegations of fraud are referred to the Department’s law enforcement partners pursuant to a memorandum of understanding (MOU). Parties to the MOU are the Office of the Chief State’s Attorney, the Office of the Attorney General and the U.S. Department of Health and Human Services’ Office of the Inspector General. Each entity is responsible for independently investigating the Department’s referral to determine if a criminal and/or civil action is appropriate.
The PCA Investigations Unit, which is charged with the responsibility of coordinating and conducting activities to investigate allegations of fraud committed by self-directed PCAs, PCA, and Homemaker agencies enrolled in the Connecticut Medical Assistance Program (CMAP) and other HCBS services in the Connecticut Medical Assistance Program. When appropriate, credible allegations of fraud are referred to the Department’s law enforcement partners pursuant to a memorandum of understanding (MOU). Parties to the MOU are the Office of the Chief State’s Attorney, the Office of the Attorney General and the U.S. Department of Health and Human Services’ Office of the Inspector General. Each entity is responsible for independently investigating the Department’s referral to determine if a criminal and/or civil action is appropriate.
The Provider Enrollment Unit is responsible for the review and approval of all provider enrollment and re-enrollment applications, on an on-going basis. This Unit also shares responsibility for ensuring federal and ACA requirements for provider enrollment are instituted and adhered to. Coordination of efforts between the Provider Investigations Unit and Provider Enrollment Unit strengthens Connecticut’s program integrity efforts.
We hope you pursue joining our team and encourage you to detail your related experience on the application!
