*If you are interested in applying for this position, please visit https://wisc.jobs and search for Job ID 17660. We do not accept applications through external sources.*
Job Title: Medicaid Fraud Investigator
Job ID: 17660
Location: Madison
Agency: Justice
Full/Part Time: Full-Time
Regular/Temporary: Regular
Introduction
It is the mission of the Wisconsin Department of Justice (DOJ) to protect the public and ensure that justice is done. To continue to meet this mission, the principles of equity, inclusion, and employee well-being have become a foundation for all work performed at DOJ, on behalf of Wisconsinites.
The DOJ is committed to developing and supporting a workforce and culture that is rich in diversity and innovation. It is the department’s goal to ensure that all DOJ employees are empowered to be authentic, claim belonging, and thrive. This is your opportunity to make and be the difference. Click here to learn more about DOJ.
In addition to working with a dynamic group of people, we offer amazing benefits, such as excellent health insurance, ample paid leave, flexible work schedules, and an employee assistance program that offers a variety of programs and resources to help promote wellness. Furthermore, employment within the state of Wisconsin provides job stability, work/life balance, and numerous intrinsic rewards from doing meaningful work.
Do you want to help make a difference in the lives of the public? The DOJ is currently looking for a highly motivated and talented individual to join our Division of Legal Services as a Medicaid Fraud Investigator (Auditor-Senior) in the Medicaid Fraud Control and Elder Abuse Unit.
This position is headquartered at the Risser Justice Center located at 17 West Main Street in Madison.
This recruitment may be used to fill similar vacancies for this classification over the next six (6) months.
The deadline to apply for this job announcement is Wednesday, May 7, 2025, at 11:59pm. For any questions, please contact Angie Rizner, Human Resources Specialist-Senior at [email protected] or (608) 347-9393.
Position Summary
Under the general supervision of the Unit Director and a Deputy Unit Director, the Medicaid Fraud Investigator audits complaints of patient or resident abuse and/or neglect and complaints of Medicaid fraud. These are challenging positions that plan and conduct complex criminal and civil investigative audits of financial transactions of Medicaid providers such as durable medical equipment companies, home health agencies, hospitals, medical clinics, board-and-care facilities, adult family homes, pharmacies, and other entities. This position is also responsible for planning and conducting highly complex and sensitive investigations involving patient deaths, physical abuse, neglect, or misappropriation to identify health care or Medicaid fraud. This professional position requires working independently and collaboratively in the unit and engaging in professional development.
For more information, review the position description.
Salary Information
The Medicaid Fraud Investigator (Auditor-Senior) position is in pay schedule 07 and pay range 03. The starting pay will be between $37.00 - $44.33/hour (approx. $76,960 - $92,206 annually). Pay for current or former state employees will follow the provisions found in the State of Wisconsin Compensation Plan. A 12-month probationary period may be required.
Job Details
This position may be eligible to work remotely up to 3-days per week as part of a hybrid schedule, following an initial training period. Travel to the headquarters is not eligible for travel reimbursement.
High speed internet access is required to meet the needs of remote work.
The Department of Justice does not sponsor work visas at the time of hire or anytime during employment. All persons hired will be required to verify identity and eligibility to work in the United States and complete the required Employment Eligibility Form I-9.
A background check, including fingerprints, will be completed on applicants prior to selection.
Qualifications
Please address the following in your resume and/or letter of qualifications.
Minimally qualified applicants must have the following education, training and/or experience:
Investigation and fact-finding techniques.
Planning and conducting interviews with witnesses, complainants, suspects, or defendants.
Preparing and submitting complete, detailed and accurate investigative reports.
Ability to understand and apply statutory law and administrative code.
In addition to the minimum qualifications listed above, a well-qualified applicant will also have a combination of education, training, and/or experience:
Directly investigating criminal fraud or abuse.
Participating in white collar and/or abuse investigations and prosecutions.
Reviewing or overseeing the evaluation of financial records and payments.
Leading investigations.
Ability to use software programs to compile, review, and analyze data.
How To Apply
Apply online! To apply, visit wisc.jobs, search for the Job ID or Job Title, click on “Apply for Job” to start the application process. Once logged in, click “Apply for Job” and follow the steps outlined in the application process. You will be required to submit a letter of qualifications and resume.
Each time you apply for a job; you should update and tailor your resume and letter of qualifications. You should clearly describe your education, training, and experience related to the items listed in the “Qualifications” section of the job announcement. These qualifications should be addressed in your resume and expanded upon in your letter of qualifications. This will allow a fuller assessment regarding your qualifications and those required for the job applying for.
Your resume should include the following:
Your educational background including any course work that relates to the position in which you are applying.
Your employment history, including experiences and/or duties and a summary of accomplishments and skills learned or used.
Any training or experience, including volunteer work or internships, you have related specifically to the “Qualifications” section of the assessment.
Spell out any acronyms and/or abbreviations the first time used.
Your letter of qualifications should include:
Additional information regarding your past work experience, including volunteer work and internships, or coursework you have taken.
Highlights of your most relevant skills and experiences as they related to the specific job you are applying for.
Specific examples that clearly demonstrates your level of expertise.
What not to include in your resume or letter of qualifications:
Your application materials should not include any information that is not job-related, such as race, color, religion, sex, national origin, age, creed, disability, or genetic information. Further, do not include any self-identifying information such as photos, social security numbers, political affiliation, citizen status or conviction records.
Application materials will be evaluated, and the most qualified applicants will be invited to participate in the next step of the process. References will be requested from top candidates once interviews have taken place.
NOTE: Current/former State employees interested in a permissive transfer, demotion or reinstatement consideration must also apply.
The State of Wisconsin offers a special program for qualified veterans with a 30% or greater service-connected disability. If you are a qualified veteran, please visit the Veterans Employment page for application instructions to be considered for the Veterans Non-Competitive Appointment program.
The State of Wisconsin is an Equal Opportunity and Affirmative Action employer seeking a diverse and talented workforce. Veterans, women, people of color, LGBTQIA+, and people with disabilities are encouraged to apply. We provide reasonable accommodations to qualified applicants and employees with disabilities.
We appreciate the time and effort it takes to apply for positions. If any questions arise, please contact Angie Rizner, Human Resources Specialist-Senior, at [email protected] or (608) 347-9393.
Deadline to Apply
The deadline to apply for this job announcement is Wednesday, May 7, 2025, at 11:59pm.
NLADA Mutual Insurance Co., RRG
