Colorado Department of Revenue
Medicaid Fraud Investigator (Special Agent III)
Colorado Department of Revenue, Denver, Colorado, United States, 80285
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Medicaid Fraud Investigator (Special Agent III)
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Colorado Department of Revenue 1 week ago Be among the first 25 applicants Join to apply for the
Medicaid Fraud Investigator (Special Agent III)
role at
Colorado Department of Revenue Overview
The Consumer Protection Section is seeking an experienced investigator to join the Colorado Medicaid Fraud, Abuse & Neglect Unit (MFANU). The MFANU is crucial to preventing and holding providers accountable for Medicaid fraud and patient abuse across the state of Colorado. This position is ideal for someone who seeks to expand their skills while working in a fast-paced environment and making a difference for Colorado’s most vulnerable populations. This position is not subject to the Hiring Freeze as outlined in Executive Order D 2025 009. The DOL is currently offering a sign-on bonus for new Special Agent hires of $1,500. Eligible only to hires new to the Colorado State Personnel System. Sign-On bonuses will be paid as follows: $750 at time of hire; $750 at time of certification (12 months after hire). What You Will Do
The MFANU maintains a strong commitment to ensuring Coloradans have access to high-quality care and takes an aggressive approach to preventing and prosecuting Medicaid fraud and patient abuse across the state. The Dual Missions of the MFANU are: To protect the state and federal funds dedicated to providing health care and medical services to Colorado Medicaid beneficiaries. To hold individuals accountable for the abuse, neglect, or financial exploitation of clients in board and care facilities as well as those in facilities that accept Medicaid dollars. This unit receives referrals and evaluates them to determine if they warrant further investigation and criminal prosecution in state court. The Investigator will work independently and as part of a multidisciplinary team to conduct civil and criminal investigations, litigation, and prosecution of fraudulent activity by Medicaid providers and of patient abuse. The incumbent may also be assigned to civil investigations in support of the Colorado False Claims Act and will provide technical training, advice and assistance to other law enforcement agencies in Colorado. This recruitment may also be used to fill other Special Agent positions in the Consumer Protection section. Minimum Qualifications, Substitutions, Conditions Of Employment & Appeal Rights
What We Are Looking For
Minimum Qualifications:
Please document all relevant experience in detail on your application. Experience will not be inferred or assumed. Any part-time experience listed will be prorated. Six years of professional investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency. OR A combination of directly related education (such as Criminal Justice, Psychology, or Sociology) and professional investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency equal to six (6) years. Experience must include filing felony level criminal cases in a criminal court as the lead investigator. Required Competencies:
The following knowledge, skills, and abilities are required for this position and will be considered during the selection process: Demonstrated organizational skills, including the ability to multi-task, prioritize tasks, and meet deadlines; Demonstrated work experience managing or leading large-scale or complex investigations; Strong oral and written communication skills, including the ability to communicate concisely and effectively; Customer service and interpersonal skills, including the ability to work on a team; Strong critical thinking and analytical skills. Preferred Qualifications:
In addition to the minimum qualifications, if you possess any of the following, include details on your application as this information will be used to assess qualifications: Experience investigating and researching matters involving violations of State and Federal regulations; Work experience with Medicaid or Medicare regulations and statutes; Experience investigating document-intensive white-collar fraud cases from intake to completion; Experience working with medical records and bank records during investigations; Experience with database programs (e.g., Excel or Access) for data analysis and evidence tracking; Proficiency in Spanish, Chinese, German, Vietnamese, or another commonly spoken language in Colorado; Training as a forensic interviewer; Experience planning tactical operations; Experience working with multidisciplinary investigation and prosecution teams, including with state or federal partners; Experience conducting public outreach; Certified Fraud Examiner; Experience/training as a Field Training Officer (FTO) or as a law enforcement instructor; Participation with health care fraud or elder abuse task forces or committees; Experience investigating cases involving vulnerable populations; Experience working in a fast-paced environment with an active caseload. Conditions of Employment
Colorado P.O.S.T. certification at the time of hire; physical and psychological evaluation requirements if applicable per statute; ability to travel within and outside Colorado; may work nights, weekends, and potentially early mornings; Must pass a thorough criminal and personal background check and have a valid CO driver’s license; Position may require flexible work arrangements, including a hybrid schedule after training; Colorado Department of Law participates in E-Verify.
How to Apply
A completed State of Colorado Application that fully describes education, training, and experience related to this position. Writing Sample: attach a writing sample (an affidavit preferred). If not attached, application may be removed from consideration. Veteran’s Preference: attach DD214 and any required documentation. For current or former state employees, ensure your entire work history in the State Classified System is indicated in your application. Benefits
Medical and dental health plans Employer-paid life insurance Paid vacation and sick leave; 10 paid holidays per year Public Service Loan Forgiveness qualification if applicable On-site fitness center access Flexible retirement benefits (PERA, 401K/457) Career advancement opportunities and DEI initiatives Flexible work schedules and other work-life programs The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments. The Department of Law provides reasonable accommodations for applicants with disabilities. For accommodation requests, contact the ADAAA Coordinator.
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Medicaid Fraud Investigator (Special Agent III)
role at
Colorado Department of Revenue 1 week ago Be among the first 25 applicants Join to apply for the
Medicaid Fraud Investigator (Special Agent III)
role at
Colorado Department of Revenue Overview
The Consumer Protection Section is seeking an experienced investigator to join the Colorado Medicaid Fraud, Abuse & Neglect Unit (MFANU). The MFANU is crucial to preventing and holding providers accountable for Medicaid fraud and patient abuse across the state of Colorado. This position is ideal for someone who seeks to expand their skills while working in a fast-paced environment and making a difference for Colorado’s most vulnerable populations. This position is not subject to the Hiring Freeze as outlined in Executive Order D 2025 009. The DOL is currently offering a sign-on bonus for new Special Agent hires of $1,500. Eligible only to hires new to the Colorado State Personnel System. Sign-On bonuses will be paid as follows: $750 at time of hire; $750 at time of certification (12 months after hire). What You Will Do
The MFANU maintains a strong commitment to ensuring Coloradans have access to high-quality care and takes an aggressive approach to preventing and prosecuting Medicaid fraud and patient abuse across the state. The Dual Missions of the MFANU are: To protect the state and federal funds dedicated to providing health care and medical services to Colorado Medicaid beneficiaries. To hold individuals accountable for the abuse, neglect, or financial exploitation of clients in board and care facilities as well as those in facilities that accept Medicaid dollars. This unit receives referrals and evaluates them to determine if they warrant further investigation and criminal prosecution in state court. The Investigator will work independently and as part of a multidisciplinary team to conduct civil and criminal investigations, litigation, and prosecution of fraudulent activity by Medicaid providers and of patient abuse. The incumbent may also be assigned to civil investigations in support of the Colorado False Claims Act and will provide technical training, advice and assistance to other law enforcement agencies in Colorado. This recruitment may also be used to fill other Special Agent positions in the Consumer Protection section. Minimum Qualifications, Substitutions, Conditions Of Employment & Appeal Rights
What We Are Looking For
Minimum Qualifications:
Please document all relevant experience in detail on your application. Experience will not be inferred or assumed. Any part-time experience listed will be prorated. Six years of professional investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency. OR A combination of directly related education (such as Criminal Justice, Psychology, or Sociology) and professional investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency equal to six (6) years. Experience must include filing felony level criminal cases in a criminal court as the lead investigator. Required Competencies:
The following knowledge, skills, and abilities are required for this position and will be considered during the selection process: Demonstrated organizational skills, including the ability to multi-task, prioritize tasks, and meet deadlines; Demonstrated work experience managing or leading large-scale or complex investigations; Strong oral and written communication skills, including the ability to communicate concisely and effectively; Customer service and interpersonal skills, including the ability to work on a team; Strong critical thinking and analytical skills. Preferred Qualifications:
In addition to the minimum qualifications, if you possess any of the following, include details on your application as this information will be used to assess qualifications: Experience investigating and researching matters involving violations of State and Federal regulations; Work experience with Medicaid or Medicare regulations and statutes; Experience investigating document-intensive white-collar fraud cases from intake to completion; Experience working with medical records and bank records during investigations; Experience with database programs (e.g., Excel or Access) for data analysis and evidence tracking; Proficiency in Spanish, Chinese, German, Vietnamese, or another commonly spoken language in Colorado; Training as a forensic interviewer; Experience planning tactical operations; Experience working with multidisciplinary investigation and prosecution teams, including with state or federal partners; Experience conducting public outreach; Certified Fraud Examiner; Experience/training as a Field Training Officer (FTO) or as a law enforcement instructor; Participation with health care fraud or elder abuse task forces or committees; Experience investigating cases involving vulnerable populations; Experience working in a fast-paced environment with an active caseload. Conditions of Employment
Colorado P.O.S.T. certification at the time of hire; physical and psychological evaluation requirements if applicable per statute; ability to travel within and outside Colorado; may work nights, weekends, and potentially early mornings; Must pass a thorough criminal and personal background check and have a valid CO driver’s license; Position may require flexible work arrangements, including a hybrid schedule after training; Colorado Department of Law participates in E-Verify.
How to Apply
A completed State of Colorado Application that fully describes education, training, and experience related to this position. Writing Sample: attach a writing sample (an affidavit preferred). If not attached, application may be removed from consideration. Veteran’s Preference: attach DD214 and any required documentation. For current or former state employees, ensure your entire work history in the State Classified System is indicated in your application. Benefits
Medical and dental health plans Employer-paid life insurance Paid vacation and sick leave; 10 paid holidays per year Public Service Loan Forgiveness qualification if applicable On-site fitness center access Flexible retirement benefits (PERA, 401K/457) Career advancement opportunities and DEI initiatives Flexible work schedules and other work-life programs The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments. The Department of Law provides reasonable accommodations for applicants with disabilities. For accommodation requests, contact the ADAAA Coordinator.
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