Compliance Investigator ; Medicaid Fraud

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 .

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 through 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.

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

Minimum Qualifications and Substitutions: 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.

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: Requires a combination of full-time college course work from an…