Top
Job Description
Description of Work
Not sure you meet all listed requirements? Let our team take a look. Research shows that women and members of other under-represented groups tend to not apply to jobs when they think they may not meet every qualification. We are committed to creating a diverse and inclusive environment and strongly encourage you to apply.
THE STARTING SALARY FOR THIS POSITION IS LIMITED TO $116,147 - $130,266. 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 Civil Attorney V is the most senior level attorney position at MID, and they handle and supervise the most complex investigations and civil actions against Medicaid providers alleged to have committed complex health care fraud schemes. These matters are pursued under the North Carolina False Claims Act and the federal False Claims Act, often in conjunction with federal partners in US Attorneys? Offices. MID provides state and national training opportunities to aid employees in understanding the complexities of health care fraud investigations. After employment, the selected candidate must be able to satisfactorily complete a detailed federal agency national security personal background investigation in order to become eligible for appointment as a SAUSA.
Civil Investigations and Litigation
The Civil Attorney V:
- will perform the highest, most advanced legal work for the State in the area of civil enforcement of health care fraud and patient abuse. The Civil Attorney V will be assigned to MID?s most complex civil matters, to include statewide investigations, ?local? qui tam (whistleblower) lawsuits filed in federal court in North Carolina, and national or ?global? qui tam lawsuits filed in federal courts across the country.
- is responsible for investigating allegations in complex healthcare fraud investigations and qui tam civil actions. Often, the qui tam actions are ?global? cases involving multiple states and the federal government, and there is extensive coordination amongst various states and the federal government.
- is responsible for analyzing case referrals to determine whether the allegations warrant opening a civil investigation and/or pursuing a civil enforcement action.
- is responsible for negotiating and drafting civil settlement agreements in complex (often multi-state) civil investigations and actions. This includes both ?local? matters within North Carolina as well as ?global? matters involving multiple states and the federal government. The ?global? matters will involve the Civil Attorney V serving on collaborative multi-state intake, investigative, and/or settlement negotiation teams.
- will, when a False Claims Act action is being litigated by the State. be responsible for all aspects of the litigation, to include discovery, motions practice, witness preparation (to include expert witnesses), and trial.
- will typically pursue False Claims Act cases in federal court. Sometimes this is done with the Civil Attorney V acting in their capacity as a Special Assistant United States Attorney (SAUSA), and sometimes they pursue the case jointly on behalf of the State with an Assistant United States Attorney acting on behalf of the federal government.
- may also be responsible for assisting and supporting criminal investigations and prosecutions as requested by MID?s Director.
Management
The Civil Attorney V:
- participates as co-leader, along with MID investigative staff, of a team of investigators or investigative teams. Teams may bring parallel criminal and civil investigations and actions. As co-leader of the team, the Civil Attorney V leads parallel civil actions and provides direction to the investigators on the civil aspects of the matter.
- provides mentoring and guidance to the Attorney III and IV Civil Attorneys.
- provides consultation and advice to the Unit Director; acts as a liaison between the Director and/or Civil Chief and civil enforcement attorneys with the United States Department of Justice and other states; and keeps the Director and/or Civil Chief apprised of important developments in civil cases.
This position requires occasional travel which may include overnight stays.
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.
Note to Current State Employees:
The salary grade for this position is LG10. 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 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.
Division Information:
This position is located in the Medicaid Investigations Division (MID) of the North Carolina Department of Justice, which is the Medicaid Fraud Control Unit (MFCU) for the State of North Carolina. 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 approximately 40% of children in North Carolina are covered by Medicaid. In 2023, approximately $16.9 billion was spent on Medicaid in North Carolina.
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 damages in a Medicaid fraud case can range from a few thousand dollars to tens of millions of dollars. MID?s enforcement actions protect and recover taxpayer funds and help ensure access to needed medical services for Medicaid enrollees.
MID is staffed by Department of Justice attorneys, investigators, auditors, analysts, and a nurse investigator, paralegals, and administrative staff. Cases are pursued in both federal and state courts in partnership with law enforcement agents from federal and state agencies such as the U.S. Department of Health and Human Services - Office of Inspector General, FBI, IRS, the North Carolina Department of Insurance, Sheriffs' Offices, and Police Departments.
MID?s Civil Section conducts investigations and brings civil actions against Medicaid providers alleged to have committed complex health care fraud schemes. We are looking for talented, team-oriented attorneys with experience in complex civil litigation who believe in our mission of protecting patients and safeguarding Medicaid funds.
Department Information:
Knowledge, Skills and Abilities / Competencies
Management Preferences:
- Experience with complex civil litigation, to include experience with litigation in federal court. While experience with healthcare fraud is preferred, it is not necessary; experience with other similarly complex litigation practice areas would be acceptable, to include complex commercial litigation, products liability litigation, medical malpractice litigation, or adult care/nursing home litigation.
- Ability to effectively initiate, supervise, and resolve complex and often lengthy civil investigations of fraud by Medicaid providers. This includes examining and analyzing many types of medical, financial and business records, often including voluminous Medicaid claims data, and presenting the findings to others (management, defense counsel, courts and juries) clearly, concisely, and persuasively, both orally and in writing.
- Working knowledge of, or the ability and willingness to become knowledgeable of, the federal and state civil laws relating to fraud by health care providers, including but not limited to the State and federal False Claims Acts, Anti-Kickback statutes, and physician self-referral laws. This includes understanding and articulating in a clear and persuasive manner the legal position of the Division in the interpretation of complex statutes, regulations, and applicable caselaw.
- Working knowledge of criminal health care fraud and the ability to recognize matters initially referred to the Division for civil action that should be investigated to determine whether a criminal health care fraud offense has been committed.
- Ability to communicate effectively on medical and financial matters before a court and jury, the ability to effectively utilize and direct medical consultants in reviews of the practices of medical providers, the ability to maintain effective working relationships with judges, related federal and state agencies and administrators, and other legal and administrative staff within the Department of justice, and the general public.
Minimum Education and Experience Requirements
Licensed to practice law by the North Carolina State Bar and five years of progressively responsible professional legal experience.
NOTE: GS 114-2 and 114-6 make it the duty of the Attorney General of NC to represent the State of North Carolina in all litigation unless another statute specifically states otherwise.
Supplemental and Contact Information
Note the following: If multiple applications are submitted to an individual posting, only the most recent application received prior to the closing date will be accepted. Applications must be submitted by 5:00 PM on the closing date.
Resumes and cover letters: To receive credit for your work history and credentials, you must list the information on the online application form. This information is used to determine if you meet the requirements of the position, and if you are selected, it is used to determine a salary offer.
Using the terms \"See Resume\" or \"See Attachment\" will not be accepted, and your application will be rejected as incomplete. Cover letters are highly encouraged but not required.
Transcripts: Degrees must be received from appropriately accredited institutions. A copy of your transcripts indicating the degree received can be uploaded with your application. If a transcript has been requested, your application will be considered incomplete if you do not provide one. Using a photograph of your diploma is not acceptable.
Credit for foreign degrees will only be given if verification of degree certification is attached to your application. Transcripts for foreign degrees have to be evaluated by an organization like World Education Services to determine US equivalency.
Any licenses or certificates must be included in the appropriate section of the application form.
Applicants seeking Veteran's Preference must attach a copy of their DD-214 or discharge orders.
Applicants seeking National Guard Preference must attach a NGB 23A (RPAS) if you are a current member of the NC National Guard in good standing. If you are a former member of the NC National Guard who served for at least 6 years and was discharged under honorable conditions, you must attach either a DD256 or NGB 22.
Application status: To check the status of your application, please log in to your account. Upon the closing date, applications are \"Under Review\" and will be screened by Human Resources for the qualified applicants. The hiring process may take an average of 6 ? 8 weeks. All applicants will be notified by email once a position is filled.
If you are having technical issues submitting your application, please call the NeoGov Help Line at 855-524-5627. If there are any questions about this posting, other than your application status, please contact the NC DOJ Human Resources office.
The NC Department of Justice is an Equal Opportunity Employer. The NC Department of Justice uses Merit-Based Recruitment to select from among the most qualified applicants to fill positions subject to the State Human Resources Act.
CONTACT INFORMATION:
NC Department of Justice
Human Resources
Human Resources
humanresources@ncdoj.gov
NOTE: For temporary, contract or other supplemental staffing appointments: There are no paid leave, retirement or other benefits associated with these appointment types.
For permanent and time-limited appointments:Eligible employees have benefits that include employee health insurance options, standard and supplemental retirement plans, NC Flex (a variety of high-quality, low-cost benefits on a pre-tax basis), and paid vacation, sick, and community service leave, to name a few. Paid parental leave is available for eligible employees. Some benefits require 30 + hours work/week for participation.