Remote Medicaid Provider Investigations Lead

Minnesota Department of Human Services; Saint Paul (MN); Hybrid; USD 94,000 - 135,000; Full time

Benefits offered by this job

Paid vacation and sick leave

12 paid holidays

Pension plan

Life insurance

Disability insurance

Job summary

The Minnesota Department of Human Services (DHS) seeks a Medicaid Provider Investigations Manager - Community-Based in St. Paul.

The role oversees executive leadership and operational management of community-based provider investigations across MHCP-funded services, including home, residential, behavioral health, and transportation. Under the Deputy Inspector General, the incumbent directs a team of investigators, develops protocols, and collaborates with federal/state partners to ensure program

Qualifications

• Five (5) years of providing direction to a work unit responsible for investigatory, compliance, or program integrity activities in community support, home and residential services providers or a comparable setting.
• Leading, supervising, or coordinating teams.
• Develop, implement and maintain written investigative protocols for community-based provider types or similar.
• Develop and maintain working relationships with internal and external partners.
• Leverage data analytics to identify trends and/or for investigative reporting.

Responsibilities

• Directs investigations involving a wide range of provider types and service delivery models.
• Develops and implements investigative practices, procedures, and protocols that support payment integrity and legitimacy of services.
• Directs a team of supervisors, lead investigators, and investigators.
• Provides subject matter expertise on service delivery models, investigative methodologies, and regulatory frameworks.
• Collaborates with federal and state law enforcement, regulatory, and program partners for coordinated oversight.

Skills

Leadership experience

Supervisory experience

Investigations

Data analysis

Job description

The Minnesota Department of Human Services (DHS) seeks a Medicaid Provider Investigations Manager - Community-Based in St. Paul.

The role oversees executive leadership and operational management of community-based provider investigations across MHCP-funded services, including home, residential, behavioral health, and transportation. Under the Deputy Inspector General, the incumbent directs a team of investigators, develops protocols, and collaborates with federal/state partners to ensure program