State of Washington Classified Job Specification
HEALTH CARE INVESTIGATOR 2
Class Series Concept
Independently performs health care investigations. Conducts investigations of alleged violations of state licensure laws or criminal statutes by health care professionals.
This is the journey level and incumbents typically work under general supervision. Incumbents are responsible for performing advanced health care investigations, practice reviews, and compliance reviews within established guidelines. Work is reviewed on a spot-check basis and after decisions have been made.
Investigate allegations against health care professionals that may impact public health and safety. Examples of allegations include providing substandard health care, unsanitary conditions, providing health care without proper licenses or credentials, drug diversions, abuse or neglect, or other inappropriate conduct or behavior;.
Formulates and writes an investigative plan with limited supervisor oversight that identifies possible RCW and WAC violations documented in the complaint, facts that need to be investigated, witnesses to be interviewed, and evidence to be gathered;
Applies a broad knowledge of unique regulations of multiple professions to conduct investigations against a range of regulated professions;
Writes and serves subpoenas to compel attendance of witnesses or the production of records. May participate in the execution of warrants;
Conducts field surveillance;
Conducts interviews of the complainant, witnesses, and respondent(s). Recognizes issues requiring knowledge of health care principles and practices in eliciting information and obtaining clarifications. Positions may apply knowledge of health care practices in cases requiring assessing appropriate standards of care;
Gathers, preserves, analyzes and evaluates documentary and physical evidence. This may include audits of health care, business, governmental and financial records;
May inspect facilities dispensing massage or reflexology services. Completes technical practice reviews and compliance reviews;
May assistance with the investigations involving medical Marijuana prescription and dispensing services;
Reviews cases with attorneys, administrators and program managers; participates in staff meetings and case conferences;
Prepares written reports that records 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;
May participate in legal proceedings, including testimony, in administrative hearings and courts as required;
Inspects regulated facilities and provides technical investigation assistance to include reviewing practices within the office setting, reviewing records, and completing practice specific checklist of inspection items. Examples of regulated facilities include those providing massage or reflexology services;
Conducts on site practice reviews at health care facilities;
May conduct general anesthesia audits and inspections to ensure compliance with applicable statutes;
May serve summary suspensions, cease and desist orders and license revocations;
Performs other duties as required.
Knowledge and Abilities
Knowledge of: statutes regulating practice and licensing of the 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.
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.
One year of experience as a Health Care Investigator 1.
A Bachelor’s degree and four years’ experience as a licensed Registered Nurse, Dentist, Physician, Veterinarian, Dental Hygienist, Chiropractor, or Certified Physician’s Assistant. All of the above-mentioned health professionals must be eligible for Washington State licensure.
Note: A Master’s or Graduate degree in one of the above professions will substitute for one year of the required experience.
Investigative experience will substitute for the required experience in the licensed field, year for year, except for two years of experience in the licensed field.
A Bachelor’s degree and six years of investigative experience with a criminal investigative entity, or experience investigating fraud and/or deceptive business practice within a regulatory entity, four years of which must include field experience. Additional investigative experience will substitute for education on a year for year basis.
Note: A Master's degree in Criminal Justice, Business or Public Administration, or a related field will substitute for two years of investigative experience, excluding field experience.
Class Specification History
New class (replaces Health Care Practice Investigator, 5359): 11-13-87
Revised definition and general revision: 6-15-90
Revised definition and minimum qualifications: 9-13-91
Revised minimum qualifications: 11-15-96
New class code: (formerly 46950) effective July 1, 2007
Revised salary range, definition, typical work, distinguishing characteristics and desirable qualifications; adopted June 30, 2017, effective July 1, 2017