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Mfcu Jobs (NOW HIRING)

EmblemHealth

Senior Investigator

New York, NY

Develop and maintain relationships with law enforcement (HHS-OIG, FBI, DOJ), regulatory agencies (DFS, MEDIC, OMIG, MFCU) and with industry peers. Provide guidance to the Fraud Investigators on SIU ...

EmblemHealth

Senior Investigator

New York, NY · On-site

$68K - $118K/yr

Develop and maintain relationships with law enforcement (HHS-OIG, FBI, DOJ), regulatory agencies (DFS, MEDIC, OMIG, MFCU) and with industry peers. Provide guidance to the Fraud Investigators on SIU ...

EmblemHealth

Senior Investigator

New York, NY

Develop and maintain relationships with law enforcement (HHS-OIG, FBI, DOJ), regulatory agencies (DFS, MEDIC, OMIG, MFCU) and with industry peers. Provide guidance to the Fraud Investigators on SIU ...

EmblemHealth

Senior Investigator

New York, NY · On-site

$68K - $118K/yr

Develop and maintain relationships with law enforcement (HHS-OIG, FBI, DOJ), regulatory agencies (DFS, MEDIC, OMIG, MFCU) and with industry peers. Provide guidance to the Fraud Investigators on SIU ...

MyFlorida

PROVIDER LIAISON - 67015295

Tampa, FL · Hybrid

$1.4K - $1.6K/wk

Collaborate with external agencies (MPI, QIO, MFCU) in addressing provider performance concerns. Perform other related duties as assigned. Minimum Qualifications * Highschool Diploma or its ...

MyFlorida

PROVIDER LIAISON - 67015295

Tampa, FL · Hybrid

$1.4K - $1.6K/wk

Collaborate with external agencies (MPI, QIO, MFCU) in addressing provider performance concerns. Perform other related duties as assigned. Minimum Qualifications * Highschool Diploma or its ...

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Mfcu information

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$17.5K

$116.5K

$290K

How much do mfcu jobs pay per year?

As of Jul 1, 2026, the average yearly pay for mfcu in the United States is $116,542.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,500.00 and $152,500.00 per year, depending on experience, location, and employer.

What are MFCU?

MFCU stands for Medicaid Fraud Control Unit. These are specialized state-level law enforcement agencies in the United States tasked with investigating and prosecuting Medicaid provider fraud as well as patient abuse or neglect in healthcare facilities that receive Medicaid funding. MFCUs work closely with federal and state agencies to ensure the integrity of the Medicaid program and protect vulnerable populations from fraud and abuse.

What are the key skills and qualifications needed to thrive as an MFCU (Medicaid Fraud Control Unit) Investigator, and why are they important?

To thrive as an MFCU Investigator, you need a background in criminal justice or a related field, investigative experience, and a strong understanding of Medicaid laws and healthcare fraud. Familiarity with case management systems, data analysis tools, and legal research platforms is typically required. Strong attention to detail, analytical thinking, and effective communication skills set top investigators apart. These abilities are essential to successfully detect, investigate, and prosecute Medicaid fraud, ensuring the integrity of public health programs.

What is the difference between Mfcu vs Loan Officer?

AspectMfcuLoan Officer
CredentialsTypically requires credit union-specific training, certifications, or licensesRequires mortgage or loan origination licenses, certifications like NMLS
Work EnvironmentWorks within credit unions, focusing on member financial servicesWorks in banks, mortgage companies, or financial institutions, focusing on loan origination
Industry UsagePrimarily in credit unionsIn banking and mortgage industries
Common Search IntentComparing roles within credit unionsUnderstanding loan origination roles

While Mfcu professionals focus on member services within credit unions, Loan Officers typically work in banks or mortgage companies handling loan applications. Both roles require relevant licenses and certifications, but their work environments and industry focus differ. Understanding these distinctions helps job seekers find the right career path in financial services.

What are common challenges faced by Member Service Representatives at a Multi-Function Credit Union (MFCU), and how can they be managed?

Member Service Representatives at a Multi-Function Credit Union (MFCU) often navigate challenges such as balancing high volumes of member inquiries, resolving complex account issues, and maintaining up-to-date knowledge of financial products. Effective time management, clear communication, and ongoing training are key to managing these demands. Many credit unions foster a collaborative environment, so team support and mentorship are available to help staff handle difficult situations and grow professionally.
More about Mfcu jobs
What cities are hiring for Mfcu jobs? Cities with the most Mfcu job openings:
What job categories do people searching Mfcu jobs look for? The top searched job categories for Mfcu jobs are:
Mfcu jobs near you
Infographic showing various Mfcu job openings in the United States as of June 2026, with employment types broken down into 97% Full Time, and 3% Part Time. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $116,542 per year, or $56 per hour.
Senior Investigator

Senior Investigator

EmblemHealth

New York, NY

Other

Posted 3 days ago

Job description

Summary of Job

Conduct complex, in-depth investigations of reported fraud involving the full range of healthcare products.  Develop and maintain relationships with law enforcement (HHS-OIG, FBI, DOJ), regulatory agencies (DFS, MEDIC, OMIG, MFCU) and with industry peers.  Provide guidance to the Fraud Investigators on SIU investigations and issues.  Assist with anti-fraud training sessions and public speaking engagements.

Responsbilities 

  • Investigate complex cases of reported fraud involving the Company's Medicaid healthcare product. 
     
  • Develop leads from various sources to review for suspect activity. 
     
  • Review claim files and develop action plans for the investigation. 
     
  • Conduct highly comprehensive interviews/interrogations with providers. 
     
  • Conduct medical records assessments, and CPT coding issues.
     
  • Provide guidance and mentor to the Fraud Investigators. 
     
  • Answer and respond to SIU Fraud Hotline cases when assigned based on schedule.
     
  • Triage complaints that come to the SIU and follow through on resolution.
     
  • Participate in meetings with providers, attorneys, law enforcement on a case-by-case basis as needed.
     
  • Attend training, conferences, webinars to keep up to date on current trends and schemes of Fraud, Waste & Abuse.
     
  • May assist with fraud awareness training sessions and public speaking engagements. 
     
  • Establish and maintain relationships with law enforcement (HHS-OIG, FBI), regulatory agencies (i.e DFS, MEDIC, OMIG, MFCU, NYS OAG), and with industry peers. 
     
  • Refer cases to law enforcement or regulatory agencies as needed.
     
  • Periodically meet with representatives from law enforcement and regulatory agencies to keep updated on current trends.
     
  • Handle and respond to Requests for Information (RFI) from law enforcement and regulatory agencies.
     
  • Perform other duties as directed, assigned, or required.

Qualifications

  • Bachelor's degree in criminal justice or related field.
     
  • AHFI and/or CFE certification  (Preferred)
     
  • 4 - 6+ years of relevant, professional work experience
     
  • Additional experience/specialized training may be considered in lieu of a bachelor's degree  (Required)
     
  • Professional investigation experience in economic or insurance related matters  (Required)
     
  • Experience in insurance claims investigation or law enforcement  (Preferred)
     
  • Strong knowledge of CPT and ICD9-CM coding, medical terminology, and treatment options  (Required)
     
  • Proficiency in MS Office - Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.  (Required)
     
  • Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences  (Required)
     
  • Attention to detail, critical thinking and problem-solving skills  (Required)
     
  • Ability to monitor and review information from materials, events, or the environment, to detect or assess problems  (Required)
Additional Information
  • Requisition ID: 1000002978_01
  • Hiring Range: $68,040-$118,800

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