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State of Washington Classified Job Specification

HEALTH CARE INVESTIGATOR 3

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HEALTH CARE INVESTIGATOR 3
428G
Category: Legal Services

Class Series Concept

See Health Care Investigator 1.

Definition

Performs complex health care investigations.  Conducts general and technical investigations of alleged violations of state licensure laws or criminal statutes by health care professionals.  Completes technical practice reviews and compliance reviews, which may include background investigation and thorough medical and financial record audits.

Distinguishing Characteristics

This is the senior-level of the series work under general direction.  Incumbents at this level perform the more complex and in-depth cases and/or serve as a lead or training resource for lower-level investigators in the series. Investigate complex health care cases having a higher sensitivity due to high profile, and involving multiple health care issues, complainants or respondents.  Incumbents are experienced in all aspects of work assigned and must understand and apply knowledge that pertains to multiple health care provider professions.

Typical Work

Conducts the more difficult, complex, investigations involving multiple health care issues, complainants, or respondents;

May guide HCIs 1 and 2 levels in the investigation of complex and detailed investigations requiring clinical knowledge and expertise; 

Uses the full range of investigative and health practice skills to research records, develop case files, gather and preserve documentary or physical evidence;

Inspects regulated facilities and provides technical investigation assistance, to include reviewing practices within the office setting, reviewing records, and completing a practice specific checklist of inspection items. Examples of regulated facilities include those providing massage or reflexology services, dental facilities and ambulance services;

May perform complex investigations involving medical Marijuana prescription and dispensing services;

Evaluate standards of health care practice; audits or analyzes hospital/office medical records and/or financial and billing records during investigations;

Conduct investigations against multiple professions with unique regulations;

 Makes independent evaluations and judgments in technical quality of care issues;

Conducts on site practice reviews at health care facilities. May conduct general anesthesia audits and inspections to ensure compliance with applicable statute;

Serves summary suspensions, cease and desist orders, and license revocations; 

Provides back up to the Health Care Investigator 4 when on leave or times when the Investigator 4 is out of the office;

May serve summary suspensions, cease and desist orders and license revocations;

Provides testimony at court or administrative hearings;

Prepares written reports that record the result of investigations and catalogs, identifies, and conveys all physical evidence and statements of witnesses in a manner adequate to support administrative action, civil actions brought by the Attorney General, and criminal cases brought by county or federal prosecutors or in cooperation with local law enforcement;

Performs other duties as required.

Knowledge and Abilities

Knowledge of: statutes regulating practice and licensing of health care professions; related laws and court decisions; rules of evidence; court procedures; principles, standards and techniques of investigations; practices, procedures and standards relevant to the health care professions; principles of biological, physical, and social sciences; principles of supervision, education and management.

Ability to: understand and interpret laws and court decisions relating to the health care professions; focus issues and assess behavior according to standards of practice in the health care professions; conduct complex investigations regarding highly technical health care issues; gather, preserve and present  material relevant and pertinent evidence; write and speak clearly, concisely, accurately and informatively; exercise mature judgment in a wide variety of situations involving contact with the public; supervise and train other investigators; organize and manage an investigative office.

Legal Requirement(s)

There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.

Desirable Qualifications

Three years of experience as a Health Care Investigator 2 within state service, or six years of experience as an investigator with a criminal justice agency or a directly allied field, three of which must include field experience preparing evidence and interviewing witnesses, respondents or suspects.

AND

A four-year college degree in a health care field, Business Administration, Public Administration, Criminal Justice, or a related field. 

A Master's degree in one of the above disciplines or a Master's degree in his or her profession or a related profession or a graduate degree in dentistry or medicine will substitute for one year of the required management or health care experience.

Additional experience may substitute for education on a year for year basis.

Class Specification History

New class: 9-13-91
Revised new class code: (formerly 46952) effective July 1, 2007
Revised salary range, definition, typical work, distinguishing characteristics, knowledge and abilities and desirable qualifications; adopted June 30, 2017, effective July 1, 2017. 

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