Investigator OR Senior Investigator / Human Services Program Representative 1 OR Human Services Program Representative 2

Working Title: Investigator OR Senior Investigator

Job Class: Human Services Program Representative 1 OR Human Services Program Representative 2

Agency: Human Services Dept

• Job ID: 95729
• 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: 07/22/2026
• Closing Date: 08/04/2026
• 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 2
• Work Shift/Work Hours: Day Shift / 8:00 a.m. - 4:30 p.m.
• Days of Work: Monday - Friday
• Travel Required: Yes
• Salary Range: $32.97 - $48.60 / hourly; $68,841 - $101,476 / 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.

• Approximately 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.
  
  

Human Services Program Representative 1

The Investigator position exists to apply knowledge and investigative expertise in order to identify, investigate, and take administrative or legal action in response to suspected fraud, waste and/or abuse of Minnesota Health Care Programs (MHCP) by enrolled providers.

Responsibilities include but are not limited to:

• Review, investigate, and appropriately resolve all cases identified through data analysis, assigned by the Manager or Supervisor, or referred by providers, recipients, other Department of Human Services (DHS) units, state, local and federal agencies, other third-party payers and the general public.
• Consult with Program Analysts, other Investigators, or management to develop criteria and parameters to identify providers activity that can be compared to other providers in order to investigator or develop potential cases for investigation.
  
  

Human Services Program Representative 2

The Senior Investigator position exists 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.

Responsibilities include but are not limited to:

• 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 of services to clients of Medical Assistance.
• Develop and implement strategies toward fraud detection, comprehensive investigations, and the development of cases that may involve civil, monetary, or criminal case actions.
• Plan, develop, and implement strategies that are designed to minimize the opportunities for program abuse.
  
  

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.**
  
  

Human Services Program Representative 1

Two (2) years of professional experience in the delivery of review and submission of claims administered by the Minnesota Health Care Programs (MHCP)

AND

Experience must demonstrate the following:

• Review and interpret health care services and billing data to determine the relevancy and importance of documents.
• Develop report formats for monitoring provider billing practices and developing cases.
• Identified policy problem areas and suggest changes and remedies if necessary.
  
  

Human Services Program Representative 2

Three (3) years of professional experience conducting regulatory investigations designed to detect, identify, correct and/or resolve instances of suspected fraud, waste, and abuse.

AND

Experience must demonstrate the following:

• Develop criteria, parameters, exceptions and limits used to identify unusual or suspect activity.
• Record and account for all investigative activities, conversations, research, and information given and received from the subject regarding the case.
• Determine which federal and/or state laws, regulations and/or policies affect the case or cases being reviewed for each identified problem area.
  
  

Preferred Qualifications

• Research, interpret, and apply provisions from the federal Code of Federal Regulations (CFR), state statute and rule, and Department of Human Services (DHS) policy as it pertains to Minnesota's health care delivery and payment systems, as well as Program Integrity Oversite (PIO) authority and functions.
• 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.
• Coordinate investigations with local, county, and state law enforcement agencies and to share mutual information within the guidelines of the Data Privacy Act.
• Auditing and accounting experience.
• Working knowledge of processing, auditing, or analyzing MHCP claims.
• Ability to adapt to changes in priorities, operations practices, policies, procedures, laws, rules, and coding systems.
• Sound understanding of the capabilities of automated computer systems and databases and be able to access, extract, manipulate and present data in different formats to support investigative activities.
• Use a personal computer, mainframe terminal and spreadsheet, database, and word processing software in relationship to their PIO functions to format, analyze, and prepare reports containing narrative and numeric data.
• Variety of experiences working effectively with others from different backgrounds and cultures.
  
  

Additional Requirements

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 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 Kimberly Ralidak at kimberly.ralidak@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
  
  

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 studentaid.gov)
  
  

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 651-259-3637 or email careers@state.mn.us and let us know the support you need.