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This position is located in the Medicaid Investigations Division of the North Carolina Department of Justice. Medicaid is the nation’s public health insurance program for people with low income. This taxpayer funded program provides critical health coverage for nearly one in five people in North Carolina and is especially crucial for children. Approximately 40% of children in North Carolina are covered by Medicaid. In 2023, approximately $16.9 billion was spent on Medicaid in North Carolina. While the overwhelming majority of medical providers are honest and provide high-quality services, there are those who steal from the program, and those who abuse patients.
The Attorney General’s Medicaid Investigations Division (MID) investigates and prosecutes health care fraud committed by Medicaid providers and the physical abuse of patients and embezzlement of patient funds in Medicaid-funded facilities. MID works closely with district attorneys’ offices, US Attorneys’ offices, federal, state and local agencies across the State. The amount of loss (theft) in a Medicaid fraud case ranges from a few thousand dollars to tens of millions of dollars. Every case helps protect and recover valuable taxpayer funds that are needed for their intended purpose of providing medical services.
We are looking for experienced, team-oriented prosecutors who believe in our mission of protecting patients and Medicaid funds.
The primary purpose of the Criminal Enforcement Attorney position is to prosecute criminal cases and assist with criminal investigations. The criminal cases involve Medicaid fraud, patient abuse, and/or misappropriation of patient funds. The Criminal Section will bring state and federal actions against Medicaid providers alleged to have committed complex health care fraud schemes.
The Criminal Enforcement Attorney position is also one of the attorney positions that fulfills the staff requirements of a MFCU contained in Title 42 of the Code of Federal Regulations, Section 1007.13(a)(1), which mandates that the MFCU staff must include “one or more attorneys experienced in the investigation or prosecution of civil fraud or criminal cases, who are capable of giving informed advice in applicable law and procedures and providing effective prosecution or liaison with other prosecutors.”
Medicaid Investigations Division (MID) is staffed by Department of Justice attorneys, investigators, auditors, analysts, and a nurse investigator, paralegals, and administrative staff. MID provides state and national training opportunities to aid employees in understanding the complexities of health care fraud investigations. Cases are tried in state and federal court in partnership with law enforcement agents with federal and state agencies such the Office of Inspector General, FBI, IRS, NC SBI, Sheriffs’ Offices, and Police Departments.
To date, the MID has recovered more than $1 billion in restitution and penalties for North Carolina.
The MID receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $8,535,748 for Federal fiscal year (FY) 2024. The remaining 25 percent, totaling $2,845,248 for FY 2024, is funded by the State of North Carolina.
- Thoroughly review all pertinent information relating to cases referred to the Division or generated by the Division.
- Ensure investigations are conducted within the parameters and in accordance with current state and federal law and court rulings.
- Determine whether there is a criminal violation of the law by thorough and precise analysis, research of documentary evidence, and interviews.
- Analyze, review and prepare state and federal arrest warrants, indictments, and other pleadings necessary to the successful prosecution of charges initiated by the Division.
- Initially, the Attorney III will prosecute almost exclusively in state court as a Special Prosecutor. After gaining experience prosecuting health care fraud in state court and receiving training, the Attorney III may be required to prosecute cases as a Special Assistant United States Attorney (“SAUSA”) in federal court. If required to prosecute cases as a SAUSA, the Attorney III will receive guidance from the United States Attorney’s Office, an Assistant United States Attorney or an experienced SAUSA. This position does not require prior federal experience.
- Supervise the preparation of cases.
- Work with investigators to investigate cases and gather sufficient evidence to support the filing of an indictment or warrant.
- Prepare discovery and analyze and respond to discovery requests and ensure that all discovery is provided as required by law.
- Perform legal research in the field of health care fraud and investigations.
- Organize trial documents to ensure their admissibility and to make them understandable to the court and jury.
- Negotiate criminal pleas in complex criminal actions, prepare agreements for criminal restitution, and analyze financial settlements proposed by opposing counsel.
- Provide legal guidance and direction to the investigators.
- Provide consultation and advice to the Criminal Chief and Director; keep the Director and Criminal Chief apprised of important developments in criminal cases.
This position requires some overtime. The North Carolina Department of Justice provides excellent representation and support to law enforcement, consumers, the State, and its people through teamwork, innovation, and a commitment to public service.
This position requires travel which may include overnight stays.
Note to Current State Employees:
The salary grade for this position is LG08. State employees are encouraged to apply for positions of interest even if the salary grade is the same as, or lower than, their current position. Please detail ALL work history including non-state service experience. If selected for this position, a new salary will be recalculated taking into consideration the quantity of relevant education and experience, funding availability, and internal equity. Based upon these factors, a pay increase MAY or MAY NOT result.
THE STARTING SALARY FOR A NEW HIRE TO THIS POSITION IS LIMITED TO $84,878 to $100,179. Salary offers for the
selected candidate are based on the candidate’s education and experience related to the position, as well as our agency budget and equity. The State of North Carolina offers employer-paid health insurance plus twelve paid holidays, generous vacation and sick leave accrual, dental, vision, and other insurance options, and retirement benefits. You can view our benefits information at Employee Benefits.
Hybrid telework opportunities are available for this position.