Job/Position DescriptionThe Office of Inspector General (OIG) Benefits Program Integrity (BPI) Field Investigator V reports to the BPI unit manager.
BPI Field Investigators conduct highly complex administrative and criminal investigations involving recipients of HHS programmatic services, such as Medicaid; the Childrenand#146;s Health Insurance Program (CHIP); the Supplemental Nutrition Assistance Program (SNAP); Temporary Assistance for Needy Families (TANF); and the Women, Infants, and Childrenand#146;s (WIC) program.
The BPI Field Investigator V is responsible for investigating referrals of fraud, waste, and abuse by HHS clients, conducting thorough research and evidence gathering activities, and determining whether the information collected represents a violation of program laws, rules, or regulations according to applicable evidentiary standards.The Field Investigator V coordinates and conducts investigations according to laws, regulations, agency policies, and professional standards.
The position reviews and analyzes records and reports from multiple agency, state, and federal databases; collaborates with both internal and external stakeholders to obtain verification and evidence; understands and applies relevant eligibility requirements; and calculates and establishes overpayment claims.
The position obtains business records affidavits, submits subpoenas, and coordinates with law enforcement or other state and federal entities.
Field Investigators are responsible for conducting investigative activities to collect evidence that satisfies either the and#147;clear and convincingand#148; standard for administrative fraud proceedings or the and#147;beyond a reasonable doubtand#148; standard for criminal fraud proceedings.
This may include obtaining subject and witness statements, conducting interrogative interviews, identifying and locating involved parties, and possibly conducting surveillance.
Field Investigators present evidence and testify at both HHS administrative hearings and criminal proceedings.
The position prepares and presents training; reviews and/or develops investigative techniques; assists with development of policies and procedures for conducting investigations; recommends improvements, changes, or modifications to BPI processes to increase efficiency and effectiveness of division activities and promote program integrity; and performs other related duties as assigned.
May assist the Electronic Benefits Trafficking (EBT) division in conducting covert benefits trafficking investigations.
Works under limited supervision with considerable latitude for the use of initiative and independent judgment.
Essential Job Functions35% Researches, collects evidence, reviews records, and examines potential criminally prosecutable allegations through multiple agency, state, and federal systems to determine program compliance and identify fraud.
Interacts and exchanges information with various internal and external stakeholders; coordinates with law enforcement organizations and other state and federal agencies; conducts subject, witness, and collateral interviews regarding suspected violators to meet stringent evidentiary standards; completes other evidence-gathering techniques as necessary to substantiate fraud; and coordinates complex investigations.
30% Coordinates, evaluates, summarizes, and documents investigative findings.
Prepares records, correspondence, and complex investigative reports.
Examines, investigates, and analyzes the clientand#146;s activities to ensure compliance with statutory standards and regulati https://jobshrportal.hhsc.state.tx.us/ENG/CareerPortal/job_profile.cfm?szOrderID=619613 Copy the URL in the preceding sentence to an Internet Explorer browser to apply to the job directly through the Texas Health and Human Services Career Portal.