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Medicaid Fraud Analyst Jobs (NOW HIRING)

Fraud Auditor

Omaha, NE · On-site

$75 - $110/hr

Reviewing, analyzing, and interpreting complex data sets, including Centers for Medicare & Medicaid Services claims data, PPP loan data, and records associated with health care fraud, defense ...

$98 - $118/hr

Exempt Work Unit: Medicaid Fraud Job Location: 1300 Broadway, Denver, CO 80203 Release Date ... Strong critical thinking and analytical skills. Preferred Qualifications In addition to the minimum ...

Showing results 41-60

Medicaid Fraud Analyst information

See salary details

$31K

$56.8K

$130.5K

How much do medicaid fraud analyst jobs pay per year?

As of Sep 7, 2026, the average yearly pay for medicaid fraud analyst in the United States is $56,776.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,000.00 and $55,000.00 per year, depending on experience, location, and employer.

What is a Medicaid fraud analyst?

Medicaid Fraud Analysts are professionals responsible for investigating, detecting, and preventing fraudulent activities within the Medicaid program. They analyze data, conduct research, and collaborate with law enforcement and other agencies to identify improper billing, false claims, or abuse of Medicaid funds. Their work helps ensure that Medicaid resources are used appropriately and that fraudsters are held accountable. Medicaid Fraud Analysts play a vital role in protecting taxpayer dollars and maintaining the integrity of the healthcare system.

What are the key skills and qualifications needed to thrive as a Medicaid fraud analyst?

To thrive as a Medicaid Fraud Analyst, you need strong analytical skills, attention to detail, and knowledge of healthcare regulations, typically supported by a bachelor’s degree in criminal justice, healthcare administration, or a related field. Familiarity with data analysis tools, case management systems, and fraud detection software is essential. Excellent communication, critical thinking, and investigative skills help you collaborate with law enforcement and present findings effectively. These abilities are vital for accurately identifying, investigating, and preventing fraudulent activities that can harm public health programs.

What are some common challenges faced by Medicaid fraud analysts when investigating potential fraud cases?

Medicaid Fraud Analysts often encounter challenges such as sifting through large volumes of complex data to identify suspicious patterns, staying updated on evolving fraud tactics, and ensuring compliance with legal and regulatory standards. Collaborating with healthcare providers, law enforcement, and legal teams requires clear communication and attention to detail. Additionally, analysts must balance thorough investigations with the need for timely resolution to prevent ongoing fraudulent activity and minimize financial losses for the Medicaid program.

What is the difference between Medicaid Fraud Analyst vs Medicaid Compliance Specialist?

AspectMedicaid Fraud AnalystMedicaid Compliance Specialist
Required CredentialsTypically a bachelor’s degree in criminal justice, healthcare administration, or related field; certifications like CFE (Certified Fraud Examiner) are commonSimilar credentials; often holds certifications like CHC (Certified in Healthcare Compliance) or CCEP (Certified Compliance & Ethics Professional)
Work EnvironmentGovernment agencies, healthcare organizations, or insurance companies focusing on fraud detectionHealthcare providers, insurance companies, or regulatory agencies ensuring compliance with Medicaid policies
Employer & Industry UsageUsed in government and private sectors to identify and investigate Medicaid fraudUsed across healthcare organizations to ensure adherence to Medicaid regulations and policies

Both roles require knowledge of Medicaid policies and investigative skills. While Medicaid Fraud Analysts focus on detecting and investigating fraud, Medicaid Compliance Specialists ensure organizations follow Medicaid rules. Both positions are vital in maintaining program integrity and often collaborate within healthcare compliance teams.

More about Medicaid Fraud Analyst jobs

What cities are hiring for Medicaid Fraud Analyst jobs?

Cities with the most Medicaid Fraud Analyst job openings:

What states have the most Medicaid Fraud Analyst jobs?

States with the most job openings for Medicaid Fraud Analyst jobs include:

Infographic showing various Medicaid Fraud Analyst job openings in the United States as of August 2026, with employment types broken down into 89% Full Time, 6% Part Time, and 5% Contract. Highlights an 82% Physical, 7% Hybrid, and 11% Remote job distribution, with an average salary of $56,776 per year, or $27.3 per hour.

Medicaid Fraud Investigator (Special Agent III)

The Colorado Attorney General's Office

Denver, CO • On-site

$98 - $118/hr

Other

This job post has expired 2 days ago. Applications are no longer accepted.


Job description

Details

Section: Consumer Protection Position Number: LAA-00044 & LAA-00576 Salary Range: $98,328.00 -$118,008.00 Yearly Apply By: Tuesday, October 7, 2025, 11:59 pm FLSA: 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 DOL is currently offering a sign-on bonus for new Special Agent hires of $1,500. Eligible only to hires new to the Colorado State Personnel System

Sign-On bonuses will be paid based on the following timeline:

  • $750.00 – Time of hire
  • $750.00 – Time of certification (12 months after hire)
Description of Job

This position is open only to Colorado state residents

WHAT YOU WILL DO

The MFANU maintains a strong commitment to ensuring that Coloradans have access to the highest quality of care from dedicated providers while continuing to take an aggressive approach to preventing and prosecuting Medicaid fraud and patient abuse across the state.

The dual missions of the MFANU are:

  • To protect the state and federal funds dedicated to providing health care and medical services to Colorado Medicaid beneficiaries.
  • To hold individuals accountable for the abuse, neglect, or financial exploitation of clients in board and care facilities as well as those in facilities that accept Medicaid dollars.

This unit receives multiple referrals and evaluates them to determine if they warrant further investigation and criminal prosecution in state court. Often, the unit acts as the lead investigative agency gathering information from partnering law enforcement and regulatory agencies, not limited to numerous local, state and federal agencies within the State of Colorado.

The Investigator position is a critical team member of the MFANU that will work both independently and as part of a multidisciplinary team to conduct 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).This position may also be assigned to civil investigations in support of the Colorado False Claims Act.Additionally, the incumbent will provide technical training, advice and assistance to other law enforcement agencies in various jurisdictions across Colorado in the investigation of such matters.

This recruitment may also be used to fill other Special Agent positions in the Consumer Protection section.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal RightsWHAT WE ARE LOOKING FORMinimum Qualifications

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.

  • Six years of professional investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency.

OR

  • A combination of directly related education (such as Criminal Justice, Psychology, or Sociology) and professional investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency equal to six (6) years. Experience must include filing felony level criminal cases in a criminal court as the lead investigator.
Required Competencies

The following knowledge, skills, and abilities are required for this position and will be considered during the selection process, including examination and/ or interview:

  • Demonstrated organizational skills, including the ability to multi-task, prioritize tasks, and meet deadlines;
  • Demonstrated work experience managing or leading large-scale or complex investigations;
  • Strong oral and written communication skills, including the ability to communicate concisely and effectively;
  • Customer service and interpersonal skills, including the ability to work on a team;
  • Strong critical thinking and analytical skills.
Preferred Qualifications

In addition to the minimum qualifications, if you possess any of the following specifically include the details on your application, as this information will be used to assess your qualifications and may be used to determine a top group of applicants.

  • Experience investigating and researching matters involving violations of State and Federal regulations;
  • Work experience with Medicaid or Medicare regulations and statutes;
  • Experience investigating document intensive white collar fraud cases from intake to completion;
  • Experience working with medical records and bank records during the course of an investigation;
  • Work experience with database programs, such as Excel or Access, used to analyze data and track evidence;
  • Proficiency in Spanish, Chinese, German, Vietnamese, or another commonly spoken language in Colorado;
  • Training as a forensic interviewer;
  • Experience in planning tactical operations;
  • Experience working with multidisciplinary investigation and prosecution teams, including with state or federal agency partners;
  • Experience/training as a FTO or as a LE instructor;
  • Participation with health care fraud or elder abuse task forces or committees;
  • Experience investigating cases involving vulnerable populations, including working cases involving victims/witnesses with developmental or intellectual disabilities.
  • Experience working in a fast-paced environment that involves managing an active caseload.
Conditions of Employment
  • Candidates must be Colorado P.O.S.T. certified at the time of application. In accordance with C.R.S. §24-31-303 (5)(a) and (b), applicants must be Colorado P.O.S.T. certified, including the requirement of completing a physical and psychological evaluation (if it has been more than three years since a physical and psychological evaluation has been conducted). Following a conditional job offer, but prior to appointment, a candidate not meeting the requirement of C.R.S. §24-31-303(5)(b) will be subject to a physical and psychological evaluation to determine fitness to serve as a peace officer. Must be proficient with a handgun. Must be available, sometimes on short notice, to travel within and outside the State of Colorado. Must be available to work nights and/or weekends when necessary to conduct fast-paced investigations, execute search warrants, or prepare for trial.
  • Applicants must pass a thorough criminal and personal background check, including a review of the personnel file from prior employment.
  • Position may be required to work outside of regular business hours, including possible early mornings, evenings, weekend, and overnight assignments. This is not an on-call position. Position must have a valid CO driver’s license.
  • This position may be eligible for flexible work arrangements, including a hybrid work schedule after an initial training period.
  • 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.
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 department’s action.

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

Please view the full job announcement for more information, including information about compensation and benefits, and to apply online.

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