Asst. Attorney General - Civil Medicaid Fraud

Assistant Attorney General – Civil Medicaid Fraud Division

The Tennessee Attorney General and Reporter represents all State officials, employees, agencies, departments, boards, and commissions in matters arising from their public duties. Such representation includes litigation, transactional assistance, and general legal advice to a wide variety of State entities. The Attorney General’s Office employs approximately 200 attorneys organized into 21 legal divisions within 6 sections.

About the Civil Medicaid Fraud Division:

The Civil Medicaid Fraud Division (CMF) is part of the Public Protection Section of the Attorney General’s Office. CMF investigates and prosecutes civil cases of Medicaid fraud against health providers and related parties under the Tennessee Medicaid False Claims Act (TMFCA) and on behalf of other state payers under the Tennessee False Claims Act (TFCA). Most of CMF’s cases result from qui tam actions brought pursuant to the TMFCA or referrals from TennCare’s Managed Care Organizations (MCOs).

CMF’s practice areas give attorneys exciting opportunities to work on complex cases in federal and state courts. These cases prosecute and deter fraud, waste and abuse committed against TennCare, other state healthcare payers, their members, and the taxpayers whose dollars fund these important state programs. The division strives to offer the best culture for litigators in public service: excellent work-product on interesting issues in a collegial and collaborative environment, while also protecting a high-quality of life outside of work.

Please note that the position requires in-person work at least three days per week.

Primary Job Duties

The duties and responsibilities of the CMF AAG include, but are not limited to, the following:

1. Case Investigation and Development

• Conduct investigations of healthcare providers, pharmaceutical companies, laboratories, manufacturers and other entities suspected of submitting false claims to TennCare and other state payers.
• Gather and examine billing records, medical documentation, contracts, and other relevant documents.
• Interview witnesses, whistleblowers (qui tam relators), and State personnel.

2. Legal Analysis and Case Preparation

• Research and apply federal and state Medicaid laws, including the federal False Claims Act, TMFCA and TFCA.
• Analyze complex billing schemes and healthcare regulations to determine violations.
• Assist in developing litigation strategy and evaluating potential settlements.
• Draft legal memoranda, civil complaints, civil investigative demands (CIDs) and subpoenas.

3. Litigation and Case Management

• Participate in civil litigation from initial investigation through resolution, judgment or appeal as necessary.
• Prepare and file pleadings, motions, and legal briefs.
• Conduct discovery, including depositions and document review.
• Coordinate with the U.S. Department of Justice, state Medicaid agencies, and multi-state working groups.
• Oversee settlement negotiations.

4. Collaboration and Coordination

• Work with internal divisions to ensure consistent enforcement across overlapping areas of authority.
• Liaise with TennCare, Medicaid program integrity units, and external stakeholders.
• Assist in compliance monitoring and post-settlement enforcement.

Qualifications

Professional Skills

• Strong knowledge of healthcare law and complex civil litigation in federal and state courts.
• Experience litigating cases under the False Claims Act, TMFCA and TFCA.
• Analytical skills for reviewing large datasets and complex financial/billing records.
• Excellent legal writing and research skills.
• Familiarity with governmental litigation procedures, including CIDs and e-discovery.

Cognitive and Interpersonal Traits

• Analytical thinker with attention to detail.
• Integrity and discretion, especially when handling sensitive health and financial information.
• Collaborative mindset — able to work effectively with investigators, nurse coders, data analysts and other attorneys.
• Persistence and initiative — willing to pursue multi-year, complex investigations and lawsuits.
• Communication skills — able to explain technical or legal findings clearly to non-legal audiences.

Educational / Background Preferences

• Juris Doctor with at least three years of complex civil litigation experience.

Prior experience in healthcare regulation preferred

TO APPLY:

Applications can be submitted via our online applicant portal:

https://agtnprod.powerappsportals.us/ApplicantSubmission/

Job Type: Full-time

Pay: $100,000.00 - $160,000.00 per year

Benefits:

• 401(k) matching
• Employee discount
• Health insurance
• Retirement plan

Work Location: In person