Preliminary Investigator / Human Services Program Representative 1

Job Details Working Title: Preliminary Investigator 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: 05/12/2026 • Closing Date: 05/14/2026 • Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office • Division/Unit: Department of Human Services (DHS) / Office of Inspector General (OIG)- Program Integrity Oversight (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 • Re-Posting: Yes • 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. Job Summary • This position was previously announced on 02/13/2026. 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. The Preliminary Investigator will apply knowledge and investigative expertise in order to identify, investigate, and take administrative or legal action in response to suspected fraud, over-utilization and/or abuse of the Minnesota Health Care Programs (MHCP) by enrolled providers. 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. Qualifications 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.** Two (2) years professional experience with investigative techniques and problem resolution skills to manage the investigation and resolution of cases within limitations set by regulations, law and policy; AND 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. Preferred Qualifications • 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. 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. Application Details 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 [email protected]. 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 [email protected]. 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 [email protected]. 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 [email protected] 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 [email protected] and let us know the support you need. Apply tot his job Apply To this Job