Indicates whether if this vacancy posting is part of the NY HELPS Program.NY HELPNo

The agency in which the vacancy exists.AgencyAttorney General, Office of the

The job title for the vacancy.TitleLegal Nurse/Medical Analyst: Medicaid Fraud Control Unit (6368)

The job title for the vacancy.Occupational CategoryLegal

The salary grade for this vacancy. Salaries are determined by salary grade and bargaining unit.Salary GradeNS

The collective bargaining unit to which this vacancy is assigned.Bargaining UnitM/C - Managerial/Confidential (Unrepresented)

The minimum and maximum of the salary range for this vacancy.Salary RangeFrom $83937 to $83937 Annually

Indicates whether this job is full-time or part-time. If the job is part-time, an estimated percentage will be provided. Employment Type Full-Time

This indicates the type of job, typically permanent, temporary, or provisional. 'Provisional' means that the appointment will be temporary until the incumbent takes and passes an appropriate civil service examination. Appointment Type Permanent

Jurisdictional class is the indicator for how this job can be filled. The classified service is governed by the Civil Service Commission, and consists of competitive, non-competitive, exempt, and labor classes. 'Competitive class' indicates that the applicant must take and pass an appropriate civil service examination. 'Non-competitive class' indicates that the applicant's qualifications will be evaluated without a civil service examination. 'Exempt class' indicates that the applicant will be evaluated by methods other than competitive or non-competitive, and that incumbents will not be granted tenure. 'Labor class' requires that applicants possess skills or other physical characteristics that cannot effectively be evaluated by other means. The unclassified service is legislatively defined, and includes such positions as elected officials, department and agency heads, and all academic personnel in public schools, colleges, and universities. Jurisdictional Class Exempt Class

Estimates the percentage of time incumbents of this vacancy will be required to travel. Travel Percentage 0%

This provides information on the expected workweek. Workweek Mon-Fri

The number of hours in the workweek, typically 37.5 or 40 for full time, or any other number for part time.Hours Per Week 37.5

Workday

The start time for this vacancy. If the agency employs flextime, this will be the earliest time this vacancy's shift can start. From 8:30 AM

The end time for this vacancy. If the agency employs flextime, this will be the latest time this vacancy's shift can end. To 5 PM

If checked, the agency allows flextime. Flextime allowed? No

If checked, this vacancy includes mandatory overtime. Mandatory overtime? No

If checked, this agency allows compressed workweek scheduling. Compressed workweek allowed? Yes

If checked, this agency allows telecommuting for this position. Telecommuting allowed? Yes

The county in which the vacancy is located. County New York

The street address where the vacancy is located. Street Address 28 Liberty Street

The city where the vacancy is located. City New York

The state where the vacancy is located (the default is New York). StateNY

The zip code where the vacancy is located. Zip Code10005

The duties that the incumbent of the vacancy will be expected to perform. Duties Description Criminal Justice Division
Medicaid Fraud Control Unit – New York City
Medical Analyst, Opportunity for Registered Nurses
Reference No. MFCU_NYC_ MA_6368
Salary is $80,537 + $3,400 in location pay
To be considered for this opportunity, submit a complete application online at ag.ny.gov/job-postings/other
The Office of the New York State Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU) is seeking experienced Registered Nurses to serve as Medical Analysts in its New York City 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 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 $94 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 securing $8.6M and significant reforms to nursing home after repeated financial fraud and resident mistreatment; the indictment and arraignment of owner of NYC pharmacy for allegedly stealing millions from Medicaid; and the sentencing of a former owner of over 20 pharmacies for running $11 Million Medicaid fraud targeting vulnerable HIV patients.

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.

The minimum qualifications required for this vacancy. 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 and 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 regarding the vacancy. Additional Comments The salary for this position is $80,537 + $3,400 in location pay. 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.

The name of the contact person for this vacancy. Name Legal Recruitment Unit

The telephone number to use for questions about this vacancy. Telephone 212-416-8080

The fax to use for this vacancy. Fax

Email address for emailing applications, or to ask questions about this vacancy. Email Address recruitment@ag.ny.gov

Address

The street address of the contact for this vacancy. Street NYS Office of the Attorney General

Legal Recruitment Unit- 28 Liberty St

The city for the contact for this vacancy. City New York

The state of the contact for this vacancy (the default is New York). State NY

The zip code for the contact for this vacancy. Zip Code 10005

Instructions for potential applicants.Notes on ApplyingHOW TO APPLY:

Applications are being received online at ag.ny.gov/job-postings/other. Applicants 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
• List of three (3) references: Only submit professional 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.