Compliance Investigator I (Medicaid Fraud)

Details

Section:
Consumer Protection
Position Number:
LAA-00580
Salary Range:
$58,872.00 - $81,228.00 Yearly
Apply By:
Tuesday, September 9, 2025, 11:59 pm
FLSA:
Non-Exempt
Work Unit:
Medicaid Fraud
Job Location:
1300 Broadway, Denver, CO 80203
Release Date:
Tuesday, August 26, 2025
Employment Type:
Full-Time
Position Type:
Classified

This position is not subject to the Hiring Freeze as outlined in Executive Order D 2025 009.

 

 

 

Find a rewarding career making a difference: Join the Office of the Attorney General!

 

The Colorado Medicaid Fraud, Abuse & Neglect Unit (MFANU) in the Consumer Protection Section has an opportunity for a Compliance Investigator to partner with the Unit’s criminal investigators and attorneys on criminal and civil investigations. This successful candidate will work on a wide variety of investigations focusing on economic crimes as well as abuse and neglect, playing an important role in building on case strategies. For this role, we’re looking for someone with strong analytical ability and criminal justice background. This is the role for you if you’re interested in utilizing your investigative skills to protect some of Colorado’s most vulnerable citizens!

 

Description of Job

This position is open only to Colorado state residents.
The Colorado Medicaid Fraud, Abuse & Neglect Unit (MFANU) conducts civil and criminal investigations, litigation, and prosecution of fraudulent activity by Medicaid providers (such as hospitals, doctors, pharmacies, nursing homes, etc.) and of patient abuse (such as physical assault, sexual assault, homicide and embezzlement of patient trust funds). The unit receives multiple referrals and evaluates them to determine if they warrant further investigation and criminal or civil prosecution in state or federal courts, often acting as the lead investigative agency gathering information from partnering law enforcement and regulatory agencies.

WHAT WILL YOU DO

The Compliance Investigator will evaluate and follow-up on complaints that come to the DOL through various channels but primarily though the online Medicaid complaint portal. The position conducts investigations of Medicaid Fraud, Abuse, and Neglect complaints, analyzes intake and referral information to determine the existence of violations, scope and pattern of unlawful activity, and direction of the investigation before making recommendations about next steps in criminal investigators.Ā 
Duties include:

  • Identifies and investigates violations of Medicaid fraud and other criminal statutes relating to standards of care for vulnerable populations;
  • Meets with and interviews complainants, witnesses, proprietors, and others to obtain information relating to the investigation for enforcement and compliance;
  • Conducts background investigations of suspects and suspect businesses, research and collect public and non-public records, collect financial records, and conduct complex financial analysis;
  • Reviews and analyze financial, business, and other evidence records; and
  • Documents work and tracks patterns/trends in complaints.

Salary note: Although a salary range is listed, salary will be set commensurate with the successful candidate’s qualifications and in compliance with the Equal Pay for Equal Work Act.

This recruitment may be used to fill multiple Compliance Investigator positions in the Department of Law, Consumer Protection section.

 

 

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

WHAT WE ARE LOOKING FOR
Ā 
Minimum Qualifications and Substitutions:Ā 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.Ā 

Experience Only:

Requires five (5) years of professional experience in investigation either as an investigator, investigative journalist, auditor or fraud specialist, or other field where you were responsible for conducting investigations. This experience must include review of initial complaints, follow up investigation, final recommendation, and further compliance.

OR

Education and Experience:Ā Requires a combination of full-time college course work from an accredited institute in criminal justice, public administration, or other closely related college course workĀ AND/ORĀ professional experience in investigation either as an investigator, investigative journalist, auditor or fraud specialist, or other field where you were responsible for conducting investigationsĀ totaling five years. This experience must include review of initial complaints, follow up investigation, final recommendation, and further compliance.

Necessary Special Requirement:
Qualified applicants must possess and maintain a valid driver’s license.

Preferred Qualifications:

In addition to the minimum qualifications, the preferred applicant will also demonstrate and clearly describe the following skills and experience in their job application:

  • Experience with Sales Force or similar data management systems
  • Experience with health care compliance and/or auditing medical billing and coding
  • Experience in criminal justice settings
  • Ability to compile and evaluate complex sets of data using spreadsheets, databases or other tools
  • Excellent analytical skills
  • Excellent judgment and decision making
  • Strong problem-solving skills
  • Ability to work with a wide variety of stakeholders
  • Strong written and oral communication skills

Conditions of Employment:

  • Applicants must pass a thorough background investigation prior to appointment.
  • This unit offers flexible work arrangements. New employees are generally expected to work in-office a minimum of one day per week. Additional flexibility will be considered for employees after a successful onboarding and training period. Please note, flexible work arrangements may change at any time based on business needs.
  • Position may need to travel and/or stay overnight (several days or weeks are possible) to accomplish testifying and/or participating in court proceedings in various jurisdictions, conduct investigative follow-up (interviews, gathering evidence, etc.) as well as participating in and/or providing training to others.
  • Position may be required, sometimes on short notice, to work outside of regular business hours, including possible early mornings, evenings, weekend, and overnight assignments as necessary to conduct fast-paced investigations and prepare for trial.
  • Colorado Department of Law participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

 

Supplemental Information

Appeal Rights:

If you receive notice that you have been eliminated from consideration for this position, you may file an appeal with the State Personnel Board or request a review by the State Personnel Director.

An appeal or review must be submitted on the official appeal form, signed by you or your representative. This form must be delivered to the State Personnel Board by email, US Mail, faxed or hand delivered within ten (10) calendar days from your receipt of notice or acknowledgement of the departmentā€™s action.

For more information about the appeals process, the official appeal form, and how to deliver it to the State Personnel Board go toĀ spb.colorado.govĀ or refer to 4 Colorado Code of Regulations (CCR) 801-1,Ā State Personnel Board Rules and Personnel Director’s Administrative Procedures, Chapter 8,Ā Resolution of Appeals and Disputes, atĀ spb.colorado.govĀ under Rules.

 

Please view theĀ fullĀ job announcementĀ for more information, including information about compensation and benefits, and to apply online.