Review Vacancy
TitleInvestigative Officer 3 (SIF)
Occupational CategoryOther Professional Careers
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $84156 to $106454 Annually
Duties Description The New York State Insurance Fund (NYSIF), Division of Confidential Investigations (DCI), is among the most active special investigations unit in the country, working with local, state, and federal authorities in the investigation, arrest and indictment of individuals and businesses suspected of fraud involving NYSIF. DCI’s mission is to reduce the instances of insurance fraud and abuse against the NYSIF, and to prevent and mitigate fraud. DCI is comprised of four separate units: Claims Fraud, Provider Fraud, Premium Fraud and Data Analytics.
Responsibilities include, but are not limited to:
Reporting to the Chief of Investigations, the Claims Teams Supervisor will be responsible for the oversight and coordination of activities and operations of DCI’s Claims team. The team supervisor’s duties include, but are not limited to, the following:
• Lead a team of investigators assigned Statewide to investigate claims fraud against the New York State Insurance Fund.
• Assist in the identification methods to detect insurance fraud and abuse at the earliest moment and mitigate the loss to the Fund.
• Acts as liaison with other local, state and federal high-level insurance fraud officials, as well as private sector leaders and organizations to identify, investigate and assist in prosecution of healthcare fraud.
• Attend meetings with their investigators and prosecutors regarding case referrals and ongoing prosecutions as well as high level fraud investigative and law enforcement officials to discuss topics relevant to compensation fraud prevention.
• Works in conjunction with other state and federal fraud investigative and law enforcement organizations to develop shared resources to detect and prevent fraud.
• Collaborate with other team supervisors within the Division as required by the Chief of Investigations or Director as necessary.
• Administers and reviews performance evaluations, probationary reports and counseling memoranda; supervises staff in the unit, provides staff with performance and disciplinary recommendations as needed.
• Monitors potential problem areas to limit vulnerability; addresses areas of deficiency and proposes and ensures implementation of remedial action.
• Handles matters of a confidential and/or sensitive nature received from the Director of Confidential Investigations, as needed.
• Assist investigators in the gathering and analyzing of documentary evidence from various NYSIF departments, private investigator reports, police reports, payroll records, business records, medical records, financial records, and policyholder records to determine the validity of allegations.
• Utilizes experience in complex and sensitive investigations which require an understanding of workers' compensation law.
• Support investigator’s database searches into people, corporations, liens, addresses and property ownership. Assist investigator to gather public and private intelligence information to support the investigations.
• Accompany team investigators in foot, stationary, and vehicle surveillance at worksites, private homes, and businesses belonging to claimants, doctors, and/or policyholders.
• Assist investigators with interviews and obtains affidavits from subjects of investigations and witnesses, including employers, co-workers, witnesses to accidents, lawyers, physicians, hospital administrators or insurance executives.
• Utilizes investigative expertise and contacts within the prosecutorial community to effectively build a strong criminal case when appropriate.
• Maintains professional contact with Legal counsel, other local, state and federal high- level insurance fraud officials, as well as private sector leaders and organizations to identify, investigate and assist in prosecution of healthcare fraud. Interacts with all levels of staff and management at NYSIF in the course of duties.
• Maintains membership in and/or attends meetings of related fraud investigative organizations to keep abreast of trends and training.
• Participates in training opportunities to enhance investigative skills for the detection of claims fraud, policy fraud and medical provider fraud.
Minimum Qualifications Minimum Qualifications:
• An associate’s degree or higher in criminal justice or related field*, OR
• Six years of insurance claims investigation experience or professional investigation experience with law enforcement agencies, OR
• Eight years of professional investigation experience involving economic or insurance related matters.
Related fields include: law enforcement, police science, criminal justice administration, criminology, criminal investigation, police studies, public justice, forensic accounting, forensic psychology, forensic science, and economic crime management.
Preferred Qualifications: One or more years of experience in a supervisory role or responsible for managing an investigator program.
Please be advised that the New York State Insurance Fund does not offer sponsorship for employment visas to employees or potential employees. Candidates sponsored for employment by an organization should be aware of their sponsorship status and the relevant expiration date(s) of that sponsorship before applying to this position.
Additional Comments For new State employees appointed to graded positions, the annual salary is the hiring rate (beginning of the Salary Range) of the position. Promotion salaries are calculated by the NYS Office of the State Comptroller in accordance with NYS Civil Service Law, OSC Payroll rules and regulations and negotiated union contracts.
Fringe Benefits:
• Competitive Compensation.
• Future Career Growth Potential.
• Open and Supportive Team-Based Environment.
• Plentiful Vacation, Personal, and Sick Leave Accruals.
• Paid State and Federal Holidays.
• Full Medical, Vision, and Dental.
• Retirement Options.
• Public Student Loan Forgiveness (PSLF).
• Possibility of Telecommuting, Flextime, and Alternative Work Schedules.
NYSIF Commitment to Diversity, Equity, and Inclusion
The New York State Insurance Fund (NYSIF) prioritizes and champions diversity, equity, and inclusion (DEI) throughout our agency. NYSIF provides equal opportunities to all employees and applicants for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability, veteran status, or any other protected category under federal, state, and local law. We believe that embracing our differences brings richness, new ideas and experiences to NYSIF, which energizes a creative and innovative work environment. We strive to foster a workplace where diverse individuals are able to participate fully in the decision-making process and have ample opportunity for advancement. We are committed to investing the necessary resources and attention to improving the engagement, retention, and promotion of the extraordinary talent we have.
Executive Order 31 commits New York State government to becoming a model employer for people with disabilities, increasing the participation of people with disabilities in state service and ensuring equal access to opportunities. NYSIF is proud to utilize best practices to recruit, hire, retain, and promote career advancement of individuals with disabilities. This includes special focus on current and prospective employees with the most significant disabilities, such as the use of supported employment, individual placement with support services, customized employment, the civil service sections 55/b and 55/c programs, internships, and job shadowing. If you are a person with a disability and wish to request that a reasonable accommodation be provided for you to participate in a job interview, please send an email to NYSIF’s Reasonable Accommodations mailbox at ra@nysif.com.
Some positions may require additional credentials or a background check to verify your identity.