Investigator in Healthcare Fraud Prevention

Join the Minnesota Department of Human Services as an Investigator focused on healthcare fraud prevention. Apply your expertise in regulatory investigations to protect vital health programs.

In this role, you will tackle fraud, waste, and abuse within Minnesota’s Medical Assistance programs. Your expertise will be essential in investigating claims and ensuring that funding is appropriately allocated. Work both independently and collaboratively within an investigative team to achieve program integrity and accountability.

Key Responsibilities:

• Review and assess cases assigned by supervision

• Consult with analysts on investigation strategies

• Document all activities related to investigations

• Analyze provider billing trends for discrepancies

• Develop and implement fraud detection methods

Requirements:

• At least two years of claim review experience with MHCP

• Three years of experience in investigative roles

• Ability to analyze complex healthcare data

• Experience in developing investigative reports

• Knowledge of relevant state and federal regulations

Make a significant impact by ensuring compliance and integrity in Minnesota’s healthcare services through your investigative efforts.
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