Senior Investigator

Working Title: Senior Investigator
Job Class: Human Services Program Representative 2
Agency: Human Services Dept

• Job ID: 89660
• Location: St. Paul
• Telework Eligible: Yes
• Full/Part Time: Full-Time
• Regular/Temporary: Unlimited
• Who May Apply: Open to all qualified job seekers
• Date Posted: 10/16/2025
• Closing Date: 11/05/2025
• Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office
• Division/Unit: Department of Human Services (DHS) / Office of Inspector General (OIG)-PIO MPAI Investigators 3
• Work Shift/Work Hours: Day Shift / 8:00 a.m. - 4:30 p.m.
• Days of Work: Monday - Friday
• Travel Required: Yes
• Salary Range: $ $47.76 / hourly; $67,651 - $99,722 / annually
• Classified Status: Classified
• Bargaining Unit/Union: 214 - MN Assoc of Professional Empl/MAPE
• FLSA Status: Nonexempt
• Designated in Connect 700 Program for Applicants with Disabilities: Yes

The Department of Human Services (DHS) is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DHS does not participate in E-Verify.

The work you'll do is more than just a job.
At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and working to improve the well-being and quality of life for all Minnesotans. The State of Minnesota is committed to equity and inclusion, and invests in employees by providing benefits, support resources, and training and development opportunities.

This position is eligible for
telework
for applicants who reside in Minnesota or in a bordering state, with supervisory approval and satisfactory performance. If you live in a state bordering Minnesota, you must live within 50 miles or less from the primary work location to be eligible for telework.
Approximately, 10% travel.
This posting is used to fill multiple vacancies.
This position exists to utilize healthcare, accounting, law enforcement, medical coding and/or criminal justice system experience to combat waste, mismanagement, misuse, and fraud in the Minnesota Medical Assistance program. The employee will function independently and as a member of an investigation team in developing and implementing strategies toward fraud detection, comprehensive investigations, and the development of cases that may involve civil, monetary, or criminal case actions. In addition, the employee will plan, develop, and implement strategies that are designed to minimize the opportunities for program abuse.

The position requires the employee independently investigate and assist other investigative staff to initiate, develop, and resolve cases which lead to administrative actions, sanctions, referrals for criminal action, and/or monetary recoveries of county, state and federal funds erroneously or fraudulently received by providers for services to covered in the Minnesota Health Care Programs.

Minimum Qualifications

• To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job held.**

Three (3) years of experience using investigative techniques to detect fraud, abuse, over-utilization, and error in health care claims.

AND

Experience must demonstrate the following:

• Develop criteria and parameters used to identify provider activity and potential cases for investigation.
• Analyze fiscal and/or statistical and healthcare claims data to identify discrepancies.
• Creation of investigative reports, referrals, and other materials for legal review and consideration in civil or criminal cases.
• Conduct on-site visits for the purpose of obtaining additional information and documentation relating to cases under investigation in order to determine if billed services were actually provided as claimed and appropriately billed in accordance with applicable program provisions.

Preferred Qualifications

• Global understanding of regulations, law and policy relating to health care services and work in-depth with provisions that directly relate to each given case.
• Apply a broad-based, comprehensive understanding of federal and state health care policy, rules, laws and requirements that allow for submission and reimbursement of claims adjudicated the Medicaid claims processing system.
• Resolve any problems relating to provider refusal to allow access to needed records.
• Auditing and accounting experience
• Working knowledge of MN 245A and 245G Licensed providers
• An understanding of claims processing operations, edits, and CPT coding practices sufficient to understand the procedures followed and decisions made by claims processing staff
• Skilled in writing legal and technical documents, i.e., Notices of Agency Action, correspondence, policies, procedures and statistical/fiscal information.
• Interpret and apply complex policies, procedures, laws and regulations necessary to support the medical and/or legal issues of cases.
• Working knowledge of Word, Excel and the basic computer programs used by Program Integrity and Oversight department.
• Effectively communicate with persons involved in cases, minimizing conflict and de-escalating conflict should it arise.
• Variety of experiences working effectively with others from different backgrounds and cultures.

Additional Requirements
Incumbent must possess and maintain a valid driver's license.

This position requires successful completion of the following:

It is the policy of the Department of Human Services that the individual selected for this position successfully complete a background investigation prior to employment, including the following components:

• Criminal background check
• Reference check
• Fingerprinting check (MNJIS/CJIS)

Complete the Criminal Justice Information System (CJIS) Security Awareness training within 3-business days from the start of employment; and successfully obtain/retain CJIS certification annually.

How To Apply
Select "Apply for Job" at the top of this page. If you have questions about applying for jobs, contact the Careers Help Desk at or email For additional information about the application process, go to

Contact

If you have questions about the position, contact Melanie LaBrie at

To receive consideration as a Connect 700 Program applicant, apply online, email the Job ID#, the Working Title and your valid Proof of Eligibility Certificate by the closing date to Carolyn Rice at

If you are an individual with a disability and need an ADA accommodation for an interview, you may contact the Department of Human Services' ADA Coordinator at or DEPARTMENT OF HUMAN for assistance.

About Human Services Dept
WE MAKE A DIFFERENCE The Minnesota Department of Human Services impacts the lives of 1.7 million people every year, helping them meet their basic needs so they can achieve their highest potential.

Working together to improve the state we love.
What do Minnesota's State employees have in common?

• A sense of purpose in their work
• Connection with their coworkers and communities
• Opportunities for personal and professional growth

Benefits
As an employee, you'll have access to one of the most affordable health insurance plans in Minnesota, along with other benefits to help you and your family be well.

Your benefits may include:

• Paid vacation and sick leave
• 12 paid holidays each year

• Low-cost medical, dental, vision, and prescription drug plans

• Fertility care, including IVF

• Diabetes care

• Dental and orthodontic care for adults and children

• 6 weeks paid leave for parents of newborn or newly adopted children

• Pension plan that provides income when you retire (after working at least three years)
• Employer paid life insurance to provide support for your family in the event of death
• Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury
• Tax-free expense accounts for health, dental, and dependent care
• Resources that provide support and promote physical, emotional, social, and financial well-being

Support to help you reach your career goals:

• Training, classes, and professional development
• Tuition reimbursement
• Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at )

Employee Assistance Program (EAP) for work/life support:

• A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance
• Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
• Daily Living/Convenience Services: Chore services, home repair, trip planning, child/elder care

Programs, resources and benefits eligibility varies
based on type of employment, agency, funding availability, union/collective bargaining agreement, location, and length of service with the State of Minnesota.

EQUAL OPPORTUNITY EMPLOYERS
Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. State agencies are committed to creating a workforce that reflects the diversity of the state and strongly encourages persons of color and Indigenous communities, members of the LGBTQIA2S+ community, individuals with disabilities, women, and veterans to apply. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve Minnesotans.

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, sex (including pregnancy, childbirth, and disabilities related to pregnancy or childbirth), gender identity, gender expression, marital status, familial status, age, sexual orientation, status regarding public assistance, disability, veteran status or activity in a local Human Rights Commission or any other characteristic protected by law.

Applicants With Disabilities
Minnesota state agencies make reasonable accommodations to their employees and applicants with disabilities. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at or email and let us know the support you need.