Agent - Medicaid Fraud Control

Job Posting Title

Agent - Medicaid Fraud Control

Agency

049 ATTORNEY GENERAL

Supervisory Organization

Office of Attorney General

Job Posting End Date

Refer to the date listed at the top of this posting, if available. Continuous if date is blank.

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Estimated Appointment End Date (Continuous if Blank)

Full/Part-Time

Full time

Job Type

Regular

Compensation

Job Description

Title: Agent

 

Unit: Medicaid Fraud Control Unit

 

Salary Range: $68,000 - $90,000, commensurate with experience and qualifications

 

Location of Work: Oklahoma City, OK

 

FLSA Status: Non-exempt

 

Schedule: Full-time

 

Position Description:

The Oklahoma Medicaid Fraud Control Unit (MFCU) is a state law enforcement division within the Oklahoma Attorney General’s Office, and its mission is to investigate and pursue enforcement actions against health care providers who have defrauded the Medicaid program or who have engaged in abuse, neglect, and/or exploitation of persons in the Medicaid system or residential health care facilities.  The MFCU has both civil and criminal enforcement powers. 

 

The successful candidate for this position will work as a member of an interdisciplinary team of investigative agents, auditors/analysts, attorneys, and administrative personnel, seeking civil remedies such as financial restitution and penalties, divestment or forfeiture, and exclusions from the Medicaid system, and/or pursuing criminal enforcement actions such as fines, incarceration, and exclusions from the Medicaid system.  The successful candidate for this position should have sound judgment, strong investigative, research, and analysis skills.  The Agent serving in this position will consult with attorneys and analysts, take part in crafting and executing investigative plans, gather and review evidence, provide evidence and other information to attorneys and analysts, and testify as needed.   Additionally, the position will involve taking part in investigations and enforcement actions conducted jointly with Federal counterparts at any of the three U.S.  Attorney Offices located in Oklahoma.  This position may also involve assisting Medicaid Fraud Control Units in other States and Territories across the country as may be needed. 

 

The Agent serving in this role will also assist Unit leadership in a variety of administrative and compliance areas including, but not limited to the following:

 

• Quality Control of MFCU Investigations
• Compliance with 42 CFR Part 1007 et seq.
• Making effective and efficient use of investigative tools and resources
• Providing training specific to the health care fraud sector
• Participating in Case Reviews and audits of MFCU case work to help determine and address areas of need for things like training or supplemental effort
• Assisting Supervisory Agents with determinations about Intake assessments and referrals
• Serving as an additional point of contact for external stakeholders such as the Health Care Fraud Task Forces, the United States Attorneys Offices, the Oklahoma Health Care Authority, the Oklahoma State Department of Health, and US Department of Health and Human Services
• Investigating MFCU cases, and partnering with other MFCU Agents in active investigations for purposes of both assessment and improvement of field work and office work
• Conducting or facilitating investigations of particularly sensitive nature, as needed
• Partnering with MFCU Section Chief in communications within Unit and external to Unit
• Assisting MFCU Section Chief and MFCU Leadership with implementation of directions for MFCU team in pursuit of the MFCU mission
• Identifying and addressing training needs
• Serve as MFCU Field Training Agent and coordinate the program
• Conduct training specific to health care fraud investigations and enforcements
• Assist MFCU in recruiting, training for, and retaining Agents possessing the Certified Fraud Examiner (CFE) designation  
• Assist MFCU Leadership in discerning trends and statistics on subjects like effective Agent/Attorney combinations, success rates for MFCU Agents across particular types of investigations, and then assisting MFCU Leadership in making adjustments to personnel assignments as warranted

 

Agents of the Oklahoma Attorney General’s (OAG) Office are commissioned state law enforcement officials tasked with investigating violations and alleged violations of criminal and civil Oklahoma state statutes.  As the sole state law enforcement entity under the Oklahoma Attorney General, OAG Agents have the unique investigative and prosecutorial advantage of working with, and collaborating with, state OAG Assistant Attorneys General on a daily basis.  As commissioned state law enforcement officials, OAG Agents are automatically enrolled in, and designated beneficiaries of, the Oklahoma Law Enforcement Retirement System (OLERS).  To help ensure OAG Agents can fulfill their responsibilities to the citizens of Oklahoma as state law enforcement officials, OAG Agents are subject to medical and physical fitness evaluations.

 

The agent accepting this position must maintain the integrity of the Attorney General’s Office, as well as the confidentiality of information as required by the Oklahoma Attorney General.  In-state travel, including some overnight travel, is expected.  Also, out-of-state training opportunities will be available.

 

 

Essential Functions: 

• Develop investigative plans and investigate cases as part of a team of Agents, Supervisory Agents, Analysts, and Assistant Attorneys General as part of the MFCU team
• Communicate and collaborate with other Agents, Supervisory Agents, Analysts, and Assistant Attorneys General as part of the MFCU team
• Attend MFCU-specific training programs on an ongoing basis
• Interview witnesses, victims, and suspects, and then document investigative efforts and findings
• Maintain organized and complete records of investigative work and time expended
• Effectively and professionally research, prepare, analyze, and understand complex information and legal issues.
• Effectively manage a varying caseload of investigations of different types and levels of urgency
• Maintain the integrity of the Attorney General’s Office as well as the confidentiality of information as required by the Attorney General.
• Exercise sound judgment, and exhibit excellent report writing skills
• Prepare and provide testimony in courtroom settings
• Execute search and arrest warrants
• Maintain safety protocols of the Office of Attorney General
• Compliance with 42 CFR Part 1007.1, 42 CFR Part 1007.13, and 42 CFR Part 1007, and related regulations governing the Medicaid Fraud Control Units and their personnel
• Other duties as assigned

 

Required Qualifications: 

Qualified individuals must:

• Be a CLEET certified peace officer in Oklahoma, or eligible to become a CLEET certified peace officer through reciprocity or successfully meeting and completing the standards and requirements of the Council on Law Enforcement Education and Training (CLEET) to become a certified peace officer in Oklahoma.  (This may include successful admission to, and completion of, the CLEET Academy)
• Possess a valid Oklahoma driver's license

 

Preference will be given to individuals with:

• The Certified Fraud Examiner (CFE) designation
• A bachelor’s degree, particularly in a related field such as Accounting or Finance
• Accounting or Statistics experience
• Courtroom testimony experience
• Experience investigating matters within the healthcare and/or medical fields
• Experience with complex financial matters
• Experience investigating financial crimes
• Experience investigating fraud
• Experience investigating situations involving vulnerable victims such as the elderly, children, or the mentally and/or physically impaired
• Experience training investigators and/or law enforcement officers on investigating fraud
• Experience working as a member of an interdisciplinary or multidisciplinary team
• Experience working with members of federal law enforcement
• Proficiency with Excel and the creation and use of spreadsheets

 

All applicants must agree in writing to complete, and satisfactorily pass, a background investigation.

 

Physical Demands:

Incumbents in this position will be required to take and pass a medical physical examination and a rigorous physical fitness evaluation.  The physical fitness evaluation includes, but may not be limited to, push-ups, sit-ups, 300-meter sprint, and a mile and one-half run.  As a state law enforcement official, this position regularly requires effective utilization of all extremities, the ability to operate vehicles, objects or controls, and the ability to reach or extend hands and arms.  OAG Agents are expected to communicate effectively orally and to hear adequately within the context of interview, interrogation, and court room settings. Agents are required to be able stand, walk, stoop, kneel, crouch, and lift 50 pounds.  As a state law enforcement official, an OAG Agents is expected to work effectively in different types of environmental settings including, but not limited to, offices, outdoors, and extreme or hazardous weather conditions.

 

Mental Demands:

While performing the duties of this position, the employee must be able to use written and oral communication skills; read and interpret data, information and documents; interpret policies and procedures; learn and apply new information or new skills; work under deadlines with some interruptions; effectively organize and conduct multiple and distinct investigations,  interact well with OAG staff and other organizations; and interact effectively with suspects, victims, other law enforcement officers, Court officials, and the general public.  The incumbent will be required to take and pass a preliminary psychological assessment (MMPI).

 

Work Environment:

As a state law enforcement official, OAG Agents are expected to work effectively in different types of environmental settings including, but not limited to, offices, courtrooms, outdoors, vehicles, and extreme or hazardous weather conditions.  The incumbent needs to have the ability to operate in a professional office environment and use standard office equipment such as computers, telephones, photocopiers, filing cabinets, and fax machines.  This position frequently calls for the incumbent to work outdoors, and within their vehicle, for long hours during all seasons.  The incumbent must have the flexibility to work non-traditional work hours such as nights, weekends, and holidays when needed.

 

Stevens Amendment Statement:

The Oklahoma Attorney General’s Office Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $4,765,464 for federal fiscal year (FY) 2026. The remaining 25 percent, totaling $1,588,483 for FY 2026, is funded by the State of Oklahoma. The federal fiscal year 2026 is defined as October 1, 2025, through September 30, 2026. 

 

The Oklahoma Office of the Attorney General is an equal opportunity employer and does not make hiring decisions on the basis of race, sex/gender, color, age, national origin, genetic information, religion, or disability, so long as the disability does not render the person unable to perform the essential functions of the position for which employed with a reasonable accommodation. If reasonable accommodations are needed to apply for this position, please contact OAG Human Resources at (405) 521-3921 or HR@oag.ok.gov. All employees of the Oklahoma Office of the Attorney General are “at will” employees.

Equal Opportunity Employment

The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability.

Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub.

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