Healthcare Fraud Auditor (HCF)

Based on cases or broad legal issues assigned to one or more Assistant United States Attorneys (AUSAs) and at the AUSA’s direction, the contractor independently plans and conducts investigations of civil or administrative matters specializing in Healthcare Fraud. Cases may concern sensitive matters, involve prominent individuals, organizations or corporations within a U.S. Attorney’s district; involve issues cutting across jurisdictional lines; and often are characterized by obscure leads, few visible records, uncooperative witnesses, and/or conflicting evidence. Investigations may be conducted solely by the USAO, or more typically, in conjunction with other federal and/or state or local agencies responsible for programs supported by federal funding. These federal agencies include, but are not limited to, the Federal Bureau of Investigation (FBI), the Department of Health and Human Services (HHS), the Office of Personnel Management (OPM), the U.S. Postal Inspection Service (USPIS), the Department of Labor (DOL), and/or the Security and Exchange Commission (SEC).

The investigator:

- Working with the assigned AUSAs and/or supervisory attorneys determines applicable administrative statutory and regulatory law, and identifies possible violations or causes of action.

- Develops an understanding of all applicable federal, state, or local laws to the extent necessary to make sound decisions on direction and scope of investigations. Determines proof required to assist in affixing legal responsibility for litigation, and devises methods for obtaining, preserving, and presenting evidence to greatest effect.

- Decides upon most efficacious methods for planning, scheduling, and conducting investigations, and identifies any resources that may be required.

- Refers evidence of criminal activities to appropriate criminal investigators or sworn law enforcement officers