Forensic Fraud Examiner (Hybrid)

Introduction

\r\n\r\n\r\n\r\nDo you have experience conducting investigations of complex financial records in matters under investigation by state/federal agencies or law enforcement authorities? If this sounds like you, then we invite you to check out this opportunity to join our team as a Forensic Fraud Examiner!\r\n\r\n\r\nAt 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!\r\n\r\n\r\n\r\n\r\n\r\nPosition Highlights:\r\n\r\n\r\n This position is located at the Office of Quality Assurance, Special Investigation Division, 55 Farmington Avenue, Hartford, CT.�\r\n This full-time position (40 hours per week) has a Hybrid work schedule of Monday - Friday, 8:00 am - 4:30 pm.\r\n\r\n\r\n\r\nYour Role as a Forensic Fraud Examiner\r\nIn 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.�\r\n\r\n\r\n\r\nWhat We Can Offer You:\r\n\r\n\r\n Visit our new State Employee Benefits Overview page!\r\n 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\r\n Professional growth and development opportunities\r\n A healthy work/life balance to all employees\r\n \r\n \r\n \r\n \r\n Discover the opportunity to:\r\n \r\n \r\n Investigate complaints made to DSS and evaluate possible agency action using various resources\r\n Develop detailed fraud referral reports\r\n 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.\r\n Provide ongoing support to the investigating agencies\r\n \r\n \r\n \r\n The Special Investigations Division is comprised of the following units:\r\n 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.\r\n \r\n \r\n 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.\r\n \r\n \r\n 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.\r\n \r\n \r\n We hope you pursue joining our team and encourage you to detail your related experience on the application!\r\n \r\n

Selection Plan

FOR ASSISTANCE IN APPLYING:�\r\nCheck out our Applicant Tips on How to Apply! Need more resources?� Visit our Applicant Toolkit for additional support throughout the recruitment process.�\r\nBEFORE YOU APPLY:�\r\n\r\n Meet Minimum Qualifications: Ensure you meet the Minimum Qualifications listed on the job opening by the job closing date. You must specify your qualifications on your application. The minimum experience and training requirements listed must be met by the close date on the job opening, unless otherwise specified. �\r\n Educational Credits: List your earned credits and degrees from accredited institutions accurately on your application. To receive educational credits towards qualification, the institution must be accredited. If the institution of higher learning is located outside of the U.S., you are responsible for providing documentation from a recognized USA accrediting service which specializes in determining foreign education equivalencies to the contact listed below by the closing date listed on the job posting.�\r\n Resume Policy: Per Public Act 21-69, resumes are not accepted during the initial application process. As the recruitment process progresses, candidates may be required to submit additional documentation to support their qualification(s) for this position. This documentation may include: a cover letter, resume, transcripts, diplomas, performance reviews, attendance records, supervisory references, licensure, etc., at the request and discretion of the hiring agency.�\r\n Preferred Shift/Location: Select all location(s) and shift(s) you are willing to work on your application. Failure to do so may result in not being considered for vacancies in that specific location or shift.�\r\n Timely Submission: All application materials must be received by the job posting deadline. You will be unable to make revisions once you officially submit your application to the State. �Late submissions are rarely accepted, with exceptions only for documented events that incapacitate individuals during the entire duration of the job posting. Request exceptions by emailing DAS.SHRM@ct.gov.�\r\n Salary Calculations: For current state employees, salary calculations are not necessarily comparable from one of the three branches of state government (i.e., Executive, Legislative, Judicial) to the other.�\r\n\r\n\r\n Note: The only way to apply to this posting is via the ‘Apply’ or ‘Apply Online’ buttons on the official State of Connecticut Online Employment Center job posting.\r\n\r\nAFTER YOU APPLY:�\r\n\r\n Some email providers may experience delays or issues delivering messages. To avoid missing important updates—such as referral questionnaires or interview scheduling links—please check your Personal Status Board regularly. For added convenience, you can also enable text (SMS) notifications. To do this, log in to your Personal Status Board and select “Update My Contact Information.”\r\n Referral Questions: This posting may require completion of additional Referral Questions (RQs), which must be completed by the questionnaire’s expiration date. If requested, RQs can be accessed via an email sent to you after the job close date or by visiting your JobAps Personal Status Board (Certification Questionnaires section).���\r\n Prepare For An Interview: Interviews are limited to those whose experience and training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the best impression!�\r\n Stay connected! Log in daily to your JobAps Personal Status Board to track your status and check email (including spam/junk folders) for updates and tasks.��\r\n The immediate vacancy is listed above, however, applications to this recruitment may be used for future vacancies in this job class.��\r\n Note: This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules. Candidates who are offered and accept a position with the State of Connecticut are bound by the State Code of Ethics for Public Officials and State employees, available at www.ct.gov/ethics.\r\n\r\nQUESTIONS? WE’RE HERE TO HELP:�\r\nDue to high volume, we are unable to confirm receipt or provide status updates directly. For recruitment updates, please check your Personal Status Board and review our Frequently Asked Questions. If you have additional questions about the recruitment process, reach out to Ethan Ives at Ethan.Ives@ct.gov.\r\nJoin the State of Connecticut and take your next career step with confidence!\r\n

PURPOSE OF JOB CLASS (NATURE OF WORK)

In the Departments of Revenue Services, Social Services, and Transportation, and the Office of the Attorney General 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.\r\n

EXAMPLES OF DUTIES

\r\n Performs the most complex forensic analysis of financial records\r\n related to complex financial fraud investigations undertaken by the agency;\r\n Participates as a member of task forces on most complex cases;\r\n Reviews referred complaints for existence of financial fraud;\r\n Examines prior audit reports, financial statements, budgets or\r\n other available data for evidence of fraud, waste or abuse;\r\n Examines accounting methods and procedures to ensure compliance\r\n with accepted accounting practices;\r\n Analyzes and traces proceeds of other assets involved in\r\n fraudulent schemes;\r\n Identifies assets for possible seizure and/or forfeiture;\r\n Utilizes intelligence databases for financial records, reports and\r\n forensic analysis in investigations;\r\n Conducts interviews of witnesses and targets;\r\n Provides technical assistance to staff;\r\n Acts as a liaison with other operating units, agencies and outside\r\n officials regarding unit policies and procedures;\r\n Participates in hearings and settlement negotiations;\r\n Prepares reports and makes recommendations in investigations;\r\n Testifies in administrative and other legal proceedings regarding\r\n forensic fraud analysis and audit results;\r\n Performs related duties as required.\r\n\r\n

KNOWLEDGE, SKILL AND ABILITY

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

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

\r\n 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.\r\n 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.\r\n\r\n

PREFERRED QUALIFICATIONS

\r\n\r\n Experience using investigative interviewing techniques to gain information from individuals/groups\r\n Experience utilizing systems and applications to perform data extraction and analysis.\r\n Experience performing healthcare claims analysis\r\n Experience performing healthcare fraud investigations\r\n\r\n\r\n

SPECIAL REQUIREMENTS

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

Conclusion

AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER\r\nThe State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities.\r\n

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.\r\n