Minimum Qualifications Candidates for the Medical Analyst position must possess:
• A current NYS Registered Nurse’s license;
• A minimum of seven (7) years of clinical experience;
• Knowledge of the current standards and scope of practice for the profession of nursing, as well as knowledge of the general scope and responsibilities of nursing home staff and consultants;
• Excellent interpersonal, communication, teamwork, analytical and writing skills;
• The ability to function as an integral part of an investigative team and work in a group setting; and
• Technology proficiency that preferably includes a knowledge of and experience with Microsoft Office applications such as Outlook, Word, and Excel.
Experience in the following areas is a plus:
• Nursing administration (i.e. Director of Nursing, Administrator, Risk Manager), including current or past employment within a long-term care facility;
• Conducting investigations related to resident abuse, mistreatment or neglect, as well as quality assurance issues;
• Drug diversion investigations;
• Managed care;
• Prior experience as a legal nurse consultant; and
• Knowledge of NYS and federal rules and regulations related to health care, particularly the Medicaid program.
Duties Description The New York State Office of the Attorney General’s Medicaid Fraud Control Unit (MFCU) is seeking an experienced Registered Nurse to serve as a Medical Analyst for its New York City office. The Medical Analyst supports the Unit by working in partnership with its attorneys, auditors, detectives, data analysts, and legal support analysts to conduct complex, long-term healthcare fraud investigations. Utilizing the New York State Penal Law, the False Claims Act, Social Services Law §145-b, the Executive Law, and other New York laws, the Unit brings civil actions and criminal proceedings to successfully prosecute individuals and companies who are responsible for improper or fraudulent Medicaid billing schemes. Many of the Unit’s investigations are conducted in coordination with other state, federal or local government and prosecutorial agencies, and have resulted in revenue generation through the large-scale recovery of taxpayer money.
Additionally, MFCU investigates reports of abuse and neglect at nursing homes and other health care facilities in New York. The importance of this work is highlighted in the OAG’s recently released report investigating allegations of COVID-19-related neglect of nursing home residents across New York State. The Unit also brings civil actions and criminal proceedings to successfully prosecute individuals and companies for neglect and abuse.
Job duties will include, but are not limited to the following:
• Assisting with screening and evaluating complaints for initial follow-up, as well as aiding staff in understanding medical terminology and billing codes, and identifying inconsistent diagnoses and treatments;
• Identifying and reviewing medical records and analyzing medical documentation to identify trends in fraud, abuse, mistreatment and neglect;
• Assisting detectives in field interviews of medical personnel and experts;
• Aiding attorneys in recruiting and preparing health care witnesses (pharmacists, nurses, aides, administrators, physicians, dentists, etc.) for legal proceedings, including grand jury or trial;
• Supporting attorneys in the development of areas of questioning to be used at legal proceedings including grand jury or trial, as well as supporting and testifying in grand jury proceedings and trials;
• Assisting attorneys in reviewing legal documents for use of proper medical terminology;
• Monitoring the development and revision of professional standards within nursing and other medical fields of relevance to the Unit’s mission and advising attorneys and others on such developments and revisions; and
• Interacting with professional boards and regulatory groups as directed by attorneys in furtherance of the Unit’s mission.
Additional Comments The starting salary for this position is $72,996 + $3,026 in location pay. We offer a comprehensive New York State benefits package, including paid leave, health, dental, vision and retirement benefits, and family-friendly policies. As an employee of the OAG, you will join a team of dedicated individuals who work to serve the people of our State.
Candidates from diverse backgrounds are encouraged to apply. The OAG is an equal opportunity employer and is committed to workplace diversity.
Some positions may require additional credentials or a background check to verify your identity.
Legal Recruitment Unit- 28 Liberty St
Notes on ApplyingHOW TO APPLY:
Applications are being received online. To apply, please visit our careers website: https://ag.ny.gov/job-postings.
Reference No. MFCU_NYC_ MA_6184
Applicants must be prepared to submit a complete application consisting of the following:
• Cover Letter (You may address to Legal Recruitment);
• Writing Sample; and a
• List of three (3) professional references with contact information and email addresses.
Please note: Failure to submit a complete application will delay the consideration of your application.
If you have questions regarding a position with the OAG and the application process or you need assistance with submitting your application, please contact the Legal Recruitment via email at email@example.com or phone at 212-416-8080.
For more information about the OAG, please visit our website: ag.ny.gov.