Medical Analyst: Legal Nurse, Fraud/Patient Abuse (6413)

NY HELP No

Agency Attorney General, Office of the

Title Medical Analyst: Legal Nurse, Fraud/Patient Abuse (6413)

Occupational Category Legal

Salary Grade NS

Bargaining Unit M/C - Managerial/Confidential (Unrepresented)

Salary Range From $86953 to $86953 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Exempt Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8:30 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? Yes

Telecommuting allowed? Yes

County New York

Street Address 28 Liberty St

City New York

State NY

Zip Code 10005

Duties Description Criminal Justice Division Medicaid Fraud Control Unit - AlbanyMedical AnalystReference No. MFCU ALB MA_6393Salary is $82,953To be considered for this opportunity, submit a complete application online at ag.ny.gov/job-postings/otherThe Office of the New York State Attorney General's (OAG) Medicaid Fraud Control Unit (MFCU) is seeking an experienced Registered Nurse to serve as a Medical Analyst in its Albany office. Medical Analysts support the unit by working in partnership with its attorneys, auditors, detectives, data analysts, and legal support analysts, to conduct complex, long-term healthcare fraud and patient abuse and neglect investigations. The Medicaid program provides health coverage to millions of New Yorkers, including low-income persons, children, elderly adults, and people with developmental disabilities. MFCU is the nation's premier law enforcement agency charged with ensuring the financial integrity of New York state's $96 billion Medicaid program by investigating healthcare providers, such as pharmaceutical companies, doctors, hospitals, and nursing homes, who engage in Medicaid billing schemes that cause harm to Medicaid recipients and the loss of millions of dollars to the state of New York. MFCU also works to protect elderly and disabled New Yorkers by investigating reports of abuse and neglect in nursing homes and other residential health care facilities in the state. Possessing both civil and criminal enforcement powers, MFCU uses various state laws to bring civil actions and criminal proceedings, including asset forfeiture actions. Many of the unit's investigations are conducted in coordination with other federal, state, or local government and prosecutorial agencies, and have resulted in large-scale criminal convictions and the recovery of millions of dollars of taxpayer money. Several matters that highlight MFCU's important work include OAG's report concerning neglect of nursing home residents across New York State during the COVID-19 pandemic, and the recent filing of four major lawsuits against nursing homes, including Centers Health Care, Cold Spring Hills Center for Nursing and Rehabilitation, The Villages of Orleans Health and Rehabilitation Center, and Fulton Commons Care Center, Inc. Additional significant cases include a settlement for $656,000 from an unlicensed nursing home operator for years of fraud and neglect; securing over $7.1 million from a former Saratoga County nursing home for years of fraud and neglect; and the settlement for $8.6 million from a Long Island nursing home for repeated financial fraud and resident mistreatment.Duties: - Assisting with screening and evaluating complaints of abuse and neglect for initial follow-up, identifying aberrant diagnoses and treatments, and aiding staff in understanding medical terminology and billing codes; - Identifying and reviewing medical records and analyzing medical documentation to identify potential fraud, abuse, mistreatment, and neglect, including testifying as to such analyses in grand jury proceedings and trials;- 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 preparing for legal proceedings and reviewing legal documents for 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.

Minimum Qualifications Qualifications: - A current New York State Registered Professional 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, including 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 using Microsoft Office applications such as Outlook, Word, and Excel, and comfort with videoconferencing.Preferred skills/experience: - Nursing administration (e.g., Director of Nursing, Administrator, Risk Manager, In-Service Coordinator), 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; - Case management, MDS 3.0 Resident Assessment, and/or managed care; - Prior experience as a legal nurse consultant; and - Knowledge of state and federal rules and regulations related to health care, particularly the Medicaid program.

Additional Comments The salary for this position is $82,953. As an employee of OAG, you will join a team of dedicated individuals who work to serve the people of our state through a wide variety of occupations. We offer a comprehensive New York state benefits package, including paid leave, health, dental, vision, and retirement benefits, and family-friendly policies. Additionally, OAG offers a robust Workplace Flexibilities Program with multiple options for employees, including telecommuting (up to two days per week) and alternative work schedules. 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.

Name Legal Recruitment Unit

Telephone 212-416-8080

Fax

Email Address [email protected]

Address

Street NYS Office of the Attorney General

Legal Recruitment Unit- 28 Liberty St

City New York

State NY

Zip Code 10005

Notes on Applying HOW TO APPLY:Applications must be submitted online via this link: LGR\ JOB\ ID,P10\ POSITIONTYPE,P10\ LGR\ WRITING\ SAMPLE\ IND:6626,22,YApplicants must be prepared to submit a complete application consisting of the following:- Cover Letter: You may address your letter to Legal Recruitment. Indicate why you are interested in this position and what makes you a strong candidate. You may wish to include information about what life experiences you will bring to the position that will enhance the OAG's ability to better serve the diverse population of this state.- Resume- Medical Writing Sample- Reference List: Submit a list of three (3) references; supervisory references are preferred. For each reference, indicate the nature and duration of your relationship. Include contact information and email addresses for each reference. Please note, your references will not be contacted until after you interview for the position.