Closed listing
Preliminary Investigator / Human Services Program Representative 1
- Saint-Paul, NB, Canada
- St.-Paul, NB, Canada
Salary Range: $29.25 - $42.94 / hourly; $61,074 - $89,658 / annually · Full-time
This opening has closed.
The original listing is kept below for reference.
Job details
- Pay
- Salary Range: $29.25 - $42.94 / hourly; $61,074 - $89,658 / annually
- Job type
- Full-time
- Closing date
- Posting language
- English
- Posted
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Search current openingsOriginal job description
Archived listing. The details below describe a past opening.
Job Class: Human Services Program Representative 1
Agency: Human Services Dept
- Job ID: 92181
- 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: 09/23/2026
- Closing Date: 09/29/2026
- 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 1
- Work Shift/Work Hours: Day Shift / 8:00 a.m. - 4:30 p.m.
- Days of Work: Monday - Friday
- Travel Required: Yes
- Salary Range: $29.25 - $42.94 / hourly; $61,074 - $89,658 / 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 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 was previously announced on 02/13/2026 and 05/12/2026. If you already applied for this job, you do not need to reapply.
- This posting is used to fill multiple vacancies.
- Approximately, less than 10% travel.
- 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.
Duties will include but are not limited to the following:
- Investigation of activities related to fraud, abuse or over utilization by Minnesota Health Care Program providers.
- Review and properly conclude all cases identified through profiling, investigation, assigned by the Manager or Supervisor, through referrals from providers, recipients, other DHS state, local and federal agencies, other third-party payers and the general public.
- develop criteria and parameters which will be used to identify provider activity that can be compared to other providers to develop potential cases for investigation.
- 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.**
Experience Must Demonstrate The Following
- Working knowledge and capabilities of automated computer systems and databases and be able to access, extract, manipulate and present data in different formats to support investigative activities.
- Format, analyze, and prepare computer generated reports.
- Understanding, interpretation and application of Minnesota statutes and rules
- Working knowledge care claims processing operations, claims forms, or editing and coding structures.
- Working knowledge of the Medicaid program and the services that are provided
- Working knowledge of medical terminology and coding
- Presenting factual, investigative reports, referrals, and/or other materials for legal review and consideration in civil or criminal cases.
- This position requires a high level of organizational skills, and problem-solving skills which will require knowledge of various MHCP programs, statutes, and rules.
- Respond and adapt to changes in priorities, operations practices, policies, procedures, laws, rules and coding systems.
- Possess a 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.
- An understanding of claims, the processing operations, claims forms, edits and coding structures sufficient to be able to understand the procedures followed and decisions made by claims processing staff.
- Apply strong customer service skills while performing the regulatory functions of the job.
- Knowledge of the basic principles of civil and criminal law.
- Critical thinking skills
- Investigative skills
- A background in investigations, legal work such as a paralegal, or medical billing and/or coding.
- Variety of experiences working effectively with others from different backgrounds and cultures.
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)
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 651-259-3637 or email careers@state.mn.us. For additional information about the application process, go to http://www.mn.gov/careers.
Contact
If you have questions about the position, contact Tinna Welter at Tinna.Welter@state.mn.us.
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 carolyn.rice@state.mn.us.
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 651-431-4945 or DEPARTMENT OF HUMAN SERVICES_ADA@state.mn.us 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
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
- 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 studentaid.gov)
- 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
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 651-259-3637 or email careers@state.mn.us and let us know the support you need.
More about this job
Responsibilities
Investigate suspected fraud, abuse, and over-utilization by Minnesota Health Care Programs providers, reviewing and resolving cases from data profiling, referrals, and management assignments. Develop criteria to identify provider activity for investigation and prepare factual reports and materials for administrative or legal action.
Requirements
Requires at least two years of professional experience using investigative techniques and problem-resolution skills, along with the ability to work with databases, analyze data, and prepare reports. Candidates must understand Minnesota statutes and rules, Medicaid, healthcare claims processing, medical terminology and coding, and be able to present investigative findings for legal review; a valid driver's license is required.
Skills
- Investigative Techniques
- Problem Resolution
- Data Analysis
- Database Management
- Report Writing
- Minnesota Statutes and Rules
- Medicaid Program Knowledge
- Healthcare Claims Processing
- Medical Terminology
- Medical Coding
- Fraud Investigation
- Legal Case Preparation
- Critical Thinking
- Customer Service
- Organization
- Communication
Benefits
- Paid Vacation Leave
- Paid Sick Leave
- Paid Holidays
- Health Insurance
- Dental Insurance
- Vision Insurance
- Prescription Drug Coverage
- Fertility Care
- Paid Parental Leave
- Pension Plan
- Life Insurance
- Short-Term Disability Insurance
- Long-Term Disability Insurance
- Tax-Free Expense Accounts
- Professional Development
- Tuition Reimbursement
- Employee Assistance Program
Visa sponsorship
Not detected in the job text
Hiring contact
Tinna Welter
Hiring contact email
Tinna.Welter@state.mn.us
Categories
- Government & Public Sector
- Healthcare
- Legal
- Data & Analytics
- Security & Safety
Keywords
- Minnesota Health Care Programs
- Medicaid
- Provider Fraud
- Abuse Investigation
- Over-Utilization
- Investigative Techniques
- Case Resolution
- Data Profiling
- Automated Computer Systems
- Databases
- Data Extraction
- Data Analysis
- Computer-Generated Reports
- Minnesota Statutes
- Minnesota Rules
- Healthcare Claims Processing
- Claims Forms
- Medical Terminology
- Medical Coding
- Legal Review
- Civil Law
- Criminal Law
- CJIS Certification
- Fingerprinting
- Customer Service
- Valid Driver's License