Fraud Detection Supervisor jobs in Concord, NH

The State of New Hampshire, Employment Security, Assistant to the Commissioner - Integrity Programs, Benefit Payment Control Fraud Unit has a full-time vacancy for Fraud Specialist (Program Specialist III).

SUMMARY : Analyzes and interprets data, policies and procedures used in conducting fraud detection activities and suspected fraud investigations involving current and former recipients of state and/or federal unemployment compensation benefit programs involving misrepresentation and identity theft to protect the integrity of the Unemployment Insurance Trust Fund from loss and maintain the integrity of the unemployment insurance (UI) program.

YOUR EXPERIENCE COUNTS: Each additional year of approved formal education may be substituted for one year of required work experience and/or each additional year of approved work experience may be substituted for one year of required formal education.

MINIMUM QUALIFICATIONS:

EDUCATION : Bachelor's degree from a recognized college or university with major study in criminal justice, business or public administration, accounting or related field. Each additional year of approved formal education may be substituted for one year of required work experience.

EXPERIENCE : Four years of professional or paraprofessional experience in claims adjudication, investigations, professional audits, collections, or fact-finding work, with responsibility for program implementation, direct service delivery, planning or program evaluation. Each additional year of approved work experience may be substituted for one year of required formal education.

License/Certification :

RECOMMENDED WORK TRAITS: Considerable knowledge of federal and state laws and regulations governing fraud and overpayment of claims and of federal and community resources and organizations. Working knowledge of research and planning methods and planning techniques. Ability to communicate tactfully and effectively both orally and in writing. Ability to write technical information. Ability to understand and interpret the functional interrelationship of policy, regulations and procedures and to evaluate the impact on programs, service delivery, clients and staff. Ability to detect and define problem areas and causes and to create and develop effective solutions, including the exercise of sound judgment in evaluating situations, planning action, making decisions and settling priorities. Ability to work independently to develop new or alternative approaches to meet changing and variable conditions. Must be willing to maintain appearance appropriate to assigned duties and responsibilities as determined by the agency appointing authority.

SPECIAL REQUIREMENT: The work of an employee in trainee status in this position shall be overseen by a fully qualified individual. An employee in trainee status shall meet the minimum qualifications within the period of time specified on the SJD not to exceed one year of being hired into this position .

RESPONSIBILITIES:

Review, investigate, and make determinations on regulated activities relating to the overpayment and benefit payment fraud provision of Unemployment Compensation Law and summarize evidential material in formal investigative reports for review by Fraud Unit Supervisor and potential prosecution of fraud.

Conduct assigned investigations, to include gathering statements from victims, witnesses and suspects, collecting and evaluating pertinent records, obtaining and preparing evidence, and serving legal documents, such as subpoenas, to gain employer/claimant records and establish facts and accountability for restitution, program disqualification and/or potential for successful prosecution.

Consults with internal and external sources including, but not limited to, Cross Match National and State New Hire reporting, staff from Adjudication Units, Local Offices, Contributions, Quality Control and Appeals, the Social Security Administration and the US Department of Labor to perform risk assessment and recommend action(s) to mitigate and maintain ongoing knowledge of industry trends.

Serves as a subject matter expert for the Fraud Unit, offering insight and recommendations to improve upon or implement controls to ensure issues of fraud, and the risks it brings to the Department, are properly identified and addressed.

Performs data analysis to identify commonly used markers and manipulations of data, including bank accounts, e-mail addresses, IP addresses and investigates discrepancies and suspicious activity detected to prevent and deter earnings related fraud and resulting UI overpayments resulting from identity theft.

Researches and fully understands all internal fraud detection and mitigation practices currently in place within the Department and implements all available controls to ensure maximum effectiveness in the investigation of benefit fraud cases.

Questions suspects, parties and witnesses relating to alleged violation(s), summarizes and prepares evidential material to issue “Decisions of the Commissioner”, prepares reports of evidential material to refer cases to Prosecuting Attorney for potential civil or criminal prosecution and testifies as a witness in prosecution court cases, bankruptcy court and collections court.

Prepares and presents the Department's case of willful misrepresentation against a claimant before the Appeal Tribunal to ensure that all relevant evidence is revealed and made part of the record and obtains subpoenas to ensure claimants, employers and interested parties attend appeal hearings.

Investigates cases of suspected employer collusion to obtain benefits illegally for an employee and participates in mass investigations in selected industries to identify fraudulent Unemployment Compensation claims and potential fictitious employer schemes. Investigates specialty cases to include counterfeit checks and other potentially fraudulent activity involving the Unemployment Compensation benefit programs.

Disclaimer Statement : The supplemental job description lists the essential functions of the position and is not intended to include every job duty and responsibility specific to the position. An employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that classification.

For further information please contact Anthony Camelo, Deputy Administrator, Anthony.J.Camelo@nhes.nh.gov and 603-228-4016.

• TOTAL COMPENSATION INFORMATION

The State of NH total compensation package features an outstanding set of employee benefits, including HMO or POS Medical and Prescription Drug Benefits:

The actual value of State-paid health benefits is based on the employee's union status, and employee per pay period health benefit contributions will vary depending on the type of plan selected.

See this link for details on State-paid health benefits: https://www.das.nh.gov/hr/benefits.aspx

Value of State's share of Employee's Retirement: 13.85% of pay

Other Benefits:

Total Compensation Statement Worksheet: https://www.das.nh.gov/jobsearch/compensation-calculator.aspx

Want the specifics? Explore the Benefits of State Employment on our website:

https://www.das.nh.gov/hr/documents/BenefitBrochure.pdf

https://www.das.nh.gov/hr/index.aspx

EOE

TDD Access: Relay NH 1-800-735-2964