MCU Investigator V

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more.

Explore more details on the Benefits of Working at HHS webpage.

• Functional
  
  Title:
  
  Investigator V
• Job Title:
  
  Investigator V
• Agency:
  Health & Human Services Comm
• Department: INTERNAL AFFAIRS
• Posting Number: 21727
• Closing Date: 11/20/2026
• Posting Audience:
  Internal and External
• Occupational Category:
  Business and Financial Operations
• Salary Range: $4,801.16-$7,761.50
• Pay Frequency:
  Monthly
• Salary Group: TEXAS-B-22
• Shift: Day
• Additional Shift: None
• Telework:
  Eligible for Telework
• Travel:
  Up to 25%
• Regular/Temporary:
  Regular
• Full Time/Part Time:
  Full time
• FLSA Exempt/Non-Exempt:
  Nonexempt
• Location:
  
  Austin, 4601 W Guadalupe St

This Investigator VI is selected and managed by the Major Case Unit (MCU) manager within the Investigations & Utilization Reviews (I&UR) division of the Office of Inspector General (OIG). Performs highly advanced (senior level) investigative work involving allegations of fraud, waste, and/or abuse in the provision and delivery of all health and human services in the state. This role requires interviewing skills, extensive research & data analysis, advanced investigative skills, and the development of complex investigative reports.

Work involves up to 25% statewide travel, which may include some overnight travel. The investigator works minimal supervision with extensive latitude for the use of initiative and independent judgment.

• Research, review, and objectively investigate complex cases alleging fraud, waste, and/or abuse in the provision and delivery of all health and human services in the state. Interprets and applies applicable agency, state and federal policies, procedures, rules, and regulations. Performs timely investigative analysis in conformity with applicable policies and procedures. (35%)
• Evaluates, summarizes, and communicates investigative findings through various oral and written communications. Prepare detailed, comprehensive internal reports. Develop comprehensive fact-based exhibits to ensure effective case presentations in administrative hearings and court cases, when required. Testifies and presents evidence in informal reviews and judicial proceedings (before administrative, civil, and criminal courts) as needed. (25%)
• Research potential interviewees related to the investigation. Conducts professional interviews with recipients, witnesses, providers, complainants, and provider’s staff regarding investigations. (15%)
• Provides law enforcement assistance in criminal fraud cases to criminal investigators and prosecutors when necessary. Establishes liaisons with the Office of Attorney General’s Medicaid Fraud Control Unit, the Healthcare Program Enforcement Division, Managed Care Organizations (MCOs) other state and federal agencies, licensure boards, and other external entities to discuss and/or coordinate complex cases alleging fraud, waste, and/or abuse in the provision and delivery of all health and human services in the state.
  
  (10%)
• Develops, recommends, and implements solutions to problems. Reviews, develops, and recommends guidelines, procedures, policies, rules, and regulations to detect and prevent fraud, waste and program abuse in the provision and delivery of all health and human services in the state. Self-initiates cases or projects…