Clarification from the agency

Open to all US Citizens, including Veterans, Individuals with Disabilities, and other individuals eligible for non-competitive appointment.

• Conduct independent data analysis to identify potential new fraud investigations; complete and fulfill data analysis and information requests for law enforcement health care fraud investigations; and support and provide investigative leads.
• Apply knowledge of federal healthcare program rules, coding/claims processing systems (CPT, HCPCS, ICD), reimbursement structures, and provider and beneficiary enrollments to identify abnormalities and emerging fraud schemes.
• Design and employ appropriate algorithms to discover patterns in data sets.
• Identify patterns in claim volume, utilization, geographic distribution, or sudden changes in billing behavior that may indicate fraudulent conduct.
• Validate analytic findings using comparative analysis, sampling, and other rigorous methodologies.
• Provide expertise on program policies, claims systems, and health care benefit structures.
• Prepare written reports, presentations, and visualizations summarizing analytical results for prosecutors, management, and investigative partners.
• Provide training to DOJ staff, U.S. Attorney’s Offices, and partner agencies on health care claims data, fraud typologies, and analytic methods.

Conditions of employment

• You must be a U.S. Citizen to qualify for this position.
• You must complete the online questionnaire and additional assessment(s).
• You must undergo a pre-employment security investigation.
• Selective Service Registration is required, as applicable.
• You must meet all qualification requirements by the closing date of this announcement.
• You may be required to complete a one-year probationary period.
• Direct Deposit: All federal employees are required to have federal salary payments made by direct deposit to a financial institution of their choosing.
• The Criminal Division participates in the Electronic Employment Eligibility Verification Program. E-Verify helps employers to confirm the employment eligibility of all newly hired employees. For more information, visit https://www.e-verify.gov/.

Qualifications

To qualify at the GS-12 level, applicants must have one year of specialized experience at, or equivalent to, the GS-11 Federal grade level. Examples of specialized experience include: analyzing and interpreting data; identifying trends or patterns in data sets; validating data accuracy; and developing reports that support areas of study or investigations.

To qualify at the GS-13 level, applicants must have one year of specialized experience at, or equivalent to, the GS-12 Federal grade level. Examples of specialized experience include: conducting complex data analysis by identifying and interpreting patterns, trends and outliers in large data sets; validating analytical findings by comparing appropriate samples; leveraging data to support areas of study or investigations; and summarizing large volumes of data into clear reports for decision makers.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

Your application will be evaluated and rated under DOJ's category rating and selection procedures. In order to be considered for this position, you must complete all required steps in the process. Your qualifications will be evaluated based on your application materials (e.g, resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position. You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):


The USA Hire Assessment includes a cut score based on the minimum level of required proficiency in these critical general competencies. You must meet or exceed the cut score to be considered. You will not be considered for the position if you score below the cut score or fail to complete the assessment.

Your resume and supporting documentation will be used to determine whether you meet the job qualifications listed on this announcement. If you are basically qualified for this job, your resume and supporting documentation will be compared to your responses on the online assessment questionnaire. If you rate yourself higher than is supported by your application materials, your responses may be adjusted and/or you may be excluded from consideration for this job. Cheating on an assessment may also result in your removal from consideration. Your application will then be placed in one of three categories: Best Qualified, Highly Qualified, or Qualified. Names of all candidates in the best qualified category will be sent to the hiring official for employment consideration. Candidates within the best qualified category who are eligible for veterans' preference will receive selection priority over non-veteran preference eligibles.

Veterans' Preference and Military Spouses: If you are entitled to veterans' preference or are a military spouse, please see USAJOBS Veterans Preference for more details or visit https://www.fedshirevets.gov/job-seekers/veterans/veterans-preference/#content.

You are strongly encouraged to convert your resume to an Adobe PDF file prior to submitting your application, especially if you are submitting using a Mac system. Resumes not pre-converted to a PDF file will undergo conversion by the system. This conversion process may cause some formatting changes to your resume, including line and page break errors. To ensure your submitted resume does not display with formatting issues, please submit your resume as a PDF. This error does not affect USAjobs resumes.

To apply for this position, you must provide a complete application package which includes:

1. Resume (cover letter is optional) - Applicants will be evaluated based on a comparison of the position requirements against the quality and extent of experience or related education as reflected in their resume. Applicants are encouraged to ensure work experiences clearly show the possession of knowledge of the subject matter pertinent to the position and the technical skills to successfully perform the duties of the position. Your resume must be no more than 2 pages. If more than 2 pages are submitted, only the first 2 pages will be reviewed to determine your eligibility/qualifications. Please ensure all information you believe is qualifying for the position is contained in the first two pages, or you may be marked ineligible. Additionally, your resume must include the following information for each job listed: month and year, start/end dates (e.g. June 2007 to April 2008), and full-time or part-time status (include hours worked per week).
2. USA Hire Reasonable Accommodations Requests - If you are requesting a reasonable accommodation to the USA Hire Competency Based Assessments, you may be asked to submit documentation to support your request (https://support-usahire.opm.gov/hc/en-us/articles/45424542500371-How-to-request-a-reasonable-accommodation).
3. Documentation of Eligibility for Special Hiring Authorities (if applicable) to prove appointment eligibility. Examples include: Schedule A disability letter, Peace Corps volunteer letter, military spouse hiring authority documentation, etc.
4. Current or Former Political Appointees (if applicable) - Please note on your resume and attach an SF-50. The Office of Personnel Management (OPM) must authorize employment offers made to current or former political appointees. If you are currently, or have been within the last 5 years, a political Schedule A, Schedule C, or Non-Career SES employee in the Executive Branch, you must disclose this information to the HR Office.
5. Schedule A Documentation (if applicable) - The Criminal Division welcomes and encourages applications from persons with disabilities and is firmly committed to satisfying its affirmative obligations under the Rehabilitation Act of 1973 to ensure that persons with disabilities have every opportunity to be hired and advanced on the basis of merit within the Department. The Criminal Division also encourages eligible Schedule A applicants to submit their resumes directly to the Criminal Division disability POC at crm.schedulea@usdoj.gov.
6. CTAP or ICTAP Documentation (if applicable) - If you are a displaced Federal employee claiming eligibility under CTAP or ICTAP, you must submit:
   • A copy of the agency notice (i.e., letter of intent, separation notice, or agency RIF letter);
   • Your most recent performance appraisal; and
   • Your most recent SF-50 showing your current/former position title and series, grade, promotion potential, and duty location.
7. Veterans' Preference Documentation (if applicable):

• If you are a discharged, non-disabled veteran, you must submit a copy of your DD-214 showing character discharge (Member 4 Copy), or other documentation of service and separation under honorable conditions. If you do not have your DD-214, you may request it after discharge from the National Archives at http://www.archives.gov/veterans.
• If you are a veteran within 120 days of discharge, you must submit signed documentation from the Armed Forces certifying: 1) your expected release/retirement from active duty, 2) under honorable conditions, 3) your pay grade/rank/rate at time of discharge, 4) dates of active duty service, 5) any campaign or expeditionary medals received, and 6) dated within 120 days of your separation.
• If you are a disabled veteran, Purple Heart recipient, or parent or spouse of a disabled or deceased veteran, you must submit a completed SF-15 (https://www.opm.gov/forms/pdf_fill/SF15.pdf) and all additional proof required by the SF-15, as applicable, if you do not have your Department of Veterans Affairs letter establishing proof of disability, you may request it at https://www.va.gov/resources/getting-started-with-va/ or call 1-800-827-1000.

Next steps