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Medicaid Provider Jobs (NOW HIRING)

Jobtailor

NY · On-site

$150 - $200/hr

* Lead provider relations and contracting strategy across the Southeast Medicaid region * Develop provider engagement plans addressing market growth, network expansion, and competitive provider ...

New

CoventBridge Integrity

$60 - $80/hr

Overview Medicaid/Medicare Program Integrity Analyst II - REMOTE The Medicaid/Medicare Program ... To provide services to our clients that exceed their expectations and contribute to improved health ...

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Medicaid Provider information

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$15

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$42

How much do medicaid provider jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for medicaid provider in the United States is $27.85, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $32.69 per hour, depending on experience, location, and employer.

What is a Medicaid provider?

Medicaid providers are healthcare professionals, facilities, or organizations that are enrolled and authorized to deliver medical services to individuals covered by Medicaid, a government health insurance program for low-income individuals and families. These providers can include doctors, hospitals, clinics, pharmacies, and specialists. To become a Medicaid provider, one must meet specific state and federal requirements and agree to abide by Medicaid rules and reimbursement rates. Medicaid providers play a crucial role in ensuring access to necessary healthcare services for vulnerable populations.

What are some common challenges Medicaid providers face when coordinating care for patients?

Medicaid Providers often encounter challenges such as navigating complex regulatory requirements, managing high patient volumes, and addressing social determinants of health that impact care outcomes. These providers frequently collaborate with case managers, social workers, and other healthcare professionals to ensure patients receive comprehensive and timely services. Staying updated on policy changes and maintaining thorough documentation are also essential for compliance and effective care coordination. Building strong communication channels with both patients and interdisciplinary teams can help mitigate many of these challenges.

What are the key skills and qualifications needed to thrive as a Medicaid provider, and why are they important?

To thrive as a Medicaid Provider, you need a valid professional healthcare license (such as MD, RN, LCSW, or similar), knowledge of Medicaid regulations, and experience delivering care to diverse populations. Familiarity with Medicaid billing systems, electronic health records (EHRs), and compliance documentation is essential. Strong interpersonal skills, attention to detail, and cultural competence help providers build patient trust and accurately navigate complex requirements. These skills ensure ethical, compliant care delivery while optimizing patient outcomes and reimbursement.

What is the difference between Medicaid Provider vs Medical Billing Specialist?

AspectMedicaid ProviderMedical Billing Specialist
Required CredentialsVaries by profession; often includes licensing or certification in healthcareCertification in medical billing or coding often preferred
Work EnvironmentHealthcare facilities, clinics, or private practicesOffices, hospitals, or billing companies
Employer & Industry UsageHealthcare providers authorized to bill MedicaidHealthcare organizations managing billing processes
Search & Comparison IntentUnderstanding roles involved in Medicaid billing and servicesLearning about billing processes related to Medicaid

While Medicaid Providers are healthcare professionals or entities authorized to deliver services and bill Medicaid, Medical Billing Specialists focus on processing and managing billing claims, including Medicaid claims. Both roles are integral to Medicaid services but differ in responsibilities and credentials.

What cities are hiring for Medicaid Provider jobs?

Cities with the most Medicaid Provider job openings:

What are popular job titles related to Medicaid Provider jobs?

For Medicaid Provider jobs, the most frequently searched job titles are:

Medicaid Provider jobs near you

OAG - Medicaid Fraud Control Unit | Sergeant OAG | 26-0466

Pharr, TX • On-site

CAPPS
Human Resource Programs Administration • 10K+ employees
Learn more about CAPPSexternal

$7.4K/mo

Full-time

Posted 12 days ago

Job description

Job Description
GENERAL DESCRIPTION
The Sergeant position involves advanced criminal investigations of Medicaid provider fraud and nursing home related investigations for the Office of the Attorney General's Medicaid Fraud Control Unit (MFCU). Work involves conducting criminal investigations of violations of various state and federal statutes and prosecution assistance as needed. OAG employees enjoy excellent benefits along with tremendous opportunities to do important work and make a positive difference in the lives of all Texans.
JOB POSTING NOTICE
Applicants for this position should be prepared to pass a background investigation. Applicants will also be subject to a motor vehicle registration check. The MFCU works cases jointly with other law enforcement agencies including the FBI, U.S. Department of Health and Human Services Inspector General and IRS. In certain cases, it is necessary for our staff to have a Top Secret security clearance in order to fully participate in joint investigations or in task force activities. Top Secret clearances are not required prior to employment but in certain cases may be required at a later date. Since most security clearance problems arise from criminal records or unresolved bad credit issues, full criminal and credit checks will be run on all applicants prior to employment..
ESSENTIAL POSITION FUNCTIONS
  • Conducts complex criminal investigations of Medicaid provider fraud, and/or assures that nursing home related investigations are addressed professionally and in a timely manner, utilizing a wide range of techniques, with the goal of accomplishing the primary mission of MFCU, bringing violators of state and federal law, over which MFCU has jurisdiction, to justice, and identifying Medicaid and Medicaid related overpayments to Medicaid providers
  • Plans, participates in and conducts undercover investigations, surveillance operations, raids, and searches; identifies, gathers, and examines evidence, including complex records of Medicaid providers; executes court orders, warrants, and subpoenas; and reports investigative findings
  • Establishes and maintains liaison with outside agencies, associations, groups, and the like whose assistance and cooperation can enhance the mission of MFCU, including but not limited to proactive generation of investigative targets; participates willingly in team investigative endeavors (intraTeam, interTeam, intercity, and interagency); and contributes to a positive work environment and high morale
  • May train, lead, and/or assist with the work of others.
  • Performs related work as assigned
  • Responds to emergency situations by serving oncall twentyfour hours per day/seven days per week
  • Maintains relevant knowledge necessary to perform essential job functions
  • Attends work regularly in compliance with agreedupon work schedule
  • Ensures security and confidentiality of sensitive and/or protected information
  • Complies with all agency policies and procedures, including those pertaining to ethics and integrity

MINIMUM QUALIFICATIONS
  • Education: Graduation from high school or equivalent
  • Education: Sixty credit hours from an accredited college or university; may substitute an associate's or bachelor's degree from an accredited college or university; or fulltime investigations; law enforcement; auditing; accounting; compliance monitoring in Medicaid, Medicare, health care insurance, or closely related experience for the required education on yearforyear basis
  • Experience: Four years full time criminal investigative experience as a licensed peace officer or comparable federal law enforcement officer
    TCOLE certification
  • Knowledge of TCOLE training requirements and healthcare fraud investigation training needs
  • Knowledge of Microsoft Office products (i.e. Word, Excel, PowerPoint, Outlook)
  • Knowledge of criminal investigative principles, techniques, and methodologies
  • Knowledge of management and administrative principles, techniques, and methodologies
  • Knowledge of agency goals, objectives, rules, regulations, policies, and procedures
  • Knowledge of state and federal statutes, rules, and regulations pertaining to law enforcement activities
  • Knowledge of criminal and civil court proceedings and rules of evidence
  • Skill in effective oral and written communication (Writing sample will be required at time of interview, if selected)
  • Skill in researching and interpreting complex rules and regulations
  • Skill in applying investigative techniques and procedures
  • Skill in handling multiple tasks, prioritizing, and meeting deadlines
  • Skill in exercising sound judgment and effective decision making
  • Ability to develop and implement strategic plans and budgets
  • Ability to use and care for firearms
  • Ability to use intermediate impact weapons and Oleoresin Capsicum spray
  • Ability to use physical tactics
  • Ability to conduct complex criminal investigations of Medicaid provider fraud and nursing home related investigations
  • Ability to interpret and apply applicable provisions of the Texas Penal Code, the Texas Code of Criminal Procedure, and federal statutes pertaining to investigations
  • Ability to interpret and apply department policies and procedures
  • Ability to plan, assign, and supervise the work of others
  • Ability to handle stressful situations
  • Ability to receive and respond positively to constructive feedback
  • Ability to work cooperatively in a professional office environment
  • Ability to provide excellent customer service
  • Ability to work in person at assigned OAG work location, perform all assigned tasks at designated OAG work space within OAG work location, and perform inperson work with coworkers (e.g., collaborating, training, mentoring) for the entirety of every work week (unless on approved leave)
  • Ability to arrange for personal transportation for businessrelated travel, with reimbursement
  • Ability to work more than 40 hours as needed and in compliance with FLSA
  • Ability to lift and relocate 30 lbs.
  • Ability to travel (including overnight travel) up to 20%
  • Ability to achieve 64% or better of VO2 max on the 2000meter row, or meet a minimum score of 64% on the 500meter row test or 4minute row test, utilizing a Concept 2 Rower

PREFERRED QUALIFICATIONS
  • Experience conducting white collar/economic crime investigations
  • Experience investigating healthcare provider fraud and working with state and federal prosecutors in criminal matters
  • Accomplished practitioner of the MFCU documentation and report writing system or a like system
  • Knowledge of healthcare fraud statutes (state and federal)

TO APPLY
To apply for a job with the OAG, electronic applications can be submitted through CAPPS Recruit. A State of Texas application must be completed to be considered, and paper applications are not accepted. Your application for this position may subject you to a criminal background check pursuant to the Texas Government Code. Military Crosswalk information can be accessed at Military Crosswalk for Occupational Category Law Enforcement
THE OAG IS AN EQUAL OPPORTUNITY EMPLOYER
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About CAPPS

Sourced by ZipRecruiter

A statewide software solution developed by the Texas Department of Information Resources, CAPPS consolidates financial management, HR, and payroll operations for state agencies. Designed as a unified enterprise resource system, CAPPS replaced legacy tools in the early 2000s with a scalable, integrated platform tailored to agencies of varied size and complexity.

Industry

Human resource programs administration

Company size

10,000+ Employees

Headquarters location

Austin, TX, US

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