Medicaid Fraud Investigator/Special Agent

Salary : $99,312.00 - $123,996.00 Annually
Location : Denver, CO
Job Type: Full Time
Job Number: LAA-00564-10/2026
Department: Department of Law
Division: Consumer Protection
Opening Date: 10/26/2026
Closing Date: 11/5/2026 11:59 PM Mountain
FLSA: Determined by Position
Primary Physical Work Address: 1300 Broadway, Denver, CO 80203
Department Contact Information:
Type of Announcement: A residency waiver has been granted for this announcement. Applications will be considered from residents and non-residents of Colorado.
How To Apply: Please submit an online application for this position at https://www.governmentjobs.com/careers/colorado. Reach out to the Department Contact to apply using a paper application, including any supplemental questions. Failure to submit a complete and timely application may result in the rejection of your application. Applicants are responsible for ensuring that application materials are received by the appropriate Human Resources office before the closing date and time listed.

Department Information
The Consumer Protection Section of the Colorado Department of Law is seeking a skilled and experienced investigator to join the Colorado Medicaid Fraud, Abuse & Neglect Unit (MFANU) as a Special Agent III. The MFANU is dedicated to protecting Colorado's most vulnerable populations by investigating Medicaid provider fraud and patient abuse or neglect and holding those responsible accountable. This position offers a unique opportunity for an experienced law enforcement professional to apply their investigative expertise to complex criminal and civil cases, collaborate with multidisciplinary teams and law enforcement partners, and play a meaningful role in protecting public resources and safeguarding vulnerable individuals across Colorado. If you are a dedicated investigator who thrives on challenging cases and is passionate about public service and making a difference, we encourage you to apply.

Description of Job

ABOUT THE UNIT

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). 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. This unit provides training and technical assistance to law enforcement agencies within the State of Colorado related to Medicaid Fraud and patient abuse or neglect.

WHAT YOU WILL DO

The Special Agent III independently conducts complex criminal, civil, and administrative investigations involving Medicaid provider fraud and patient abuse or neglect. This position evaluates allegations, develops and implements investigative strategies, conducts interviews, analyzes complex financial, medical, and investigative information, and gathers, preserves, and evaluates evidence to support criminal prosecution and civil enforcement actions. The position works collaboratively with attorneys, investigators, analysts, and law enforcement partners; prepares comprehensive investigative reports, warrants, and litigation support materials; and provides testimony in court proceedings. Additional responsibilities include providing investigative guidance and training to other investigators and law enforcement agencies, participating in public outreach and education, and potentially serving as the MFANU's Property and Evidence Manager to ensure proper evidence handling, documentation, storage, and chain-of-custody compliance.

Essential duties include, but are not limited to, the following:
Criminal and Civil Investigations / Case Preparation

• Independently conduct complex criminal, civil, and administrative investigations involving Medicaid provider fraud and the abuse or neglect of patients in Medicaid-funded healthcare settings.
• Evaluate complaints and referrals to determine jurisdiction, investigative priorities, potential violations, and appropriate investigative actions.
• Develop and implement investigative plans and strategies, identify investigative leads, and determine the scope, direction, methods, and resources necessary to conduct thorough investigations.
• Investigate alleged violations of state and federal Medicaid laws, including the Colorado Medicaid False Claims Act, the federal False Claims Act, and other offenses such as theft, fraud, forgery, cybercrime, and crimes against persons.
• Conduct interviews with suspects, victims, witnesses, regulatory officials, and other individuals to gather information and develop evidence.
• Obtain, examine, and analyze complex medical, financial, billing, electronic, and other records to identify patterns of fraud, establish relevant facts, and determine the extent of potential criminal or civil wrongdoing.
• Obtain and execute search warrants, collect and preserve evidence, and utilize appropriate investigative techniques and resources in accordance with applicable laws and procedures.
• Coordinate investigative activities with attorneys, compliance investigators, forensic accountants, analysts, and local, state, and federal law enforcement agencies.
• Independently assess and prioritize assigned investigations based on public safety concerns, statutory deadlines, emerging evidence, and other factors affecting case progression.

Investigative Documentation and Evidence Analysis

• Prepare comprehensive investigative reports, affidavits, search warrants, court orders, records requests, and other legal and investigative documents.
• Document investigative activities, interviews, evidence collection, findings, and relevant information, including exculpatory evidence, in a thorough, accurate, and timely manner.
• Organize, analyze, and present complex medical, financial, and investigative information using spreadsheets, databases, charts, graphs, and other visual presentations.
• Evaluate investigative findings and determine the most appropriate methods for documenting and presenting evidence to support criminal prosecution or civil litigation.
• Prepare supporting documentation for subpoenas, search warrants, court orders, and other investigative processes in accordance with applicable legal requirements.
• Review investigative reports and supporting materials for accuracy, completeness, and compliance with investigative and evidentiary standards.

Case Agent / Prosecution and Litigation Support

• Serve as the assigned case agent in criminal and civil matters, providing investigative assistance and support throughout prosecution and litigation.
• Collaborate with prosecutors and investigative team members to evaluate evidence, identify investigative gaps, and prepare cases for presentation to a grand jury or at trial.
• Organize investigative findings, prepare exhibits, coordinate witness preparation, and assist attorneys with courtroom presentations.
• Provide testimony and serve as an advisory witness during preliminary hearings, motions hearings, jury trials, and other judicial proceedings.
• Prepare affidavits, investigative summaries, and supporting documentation for arrest warrants, search warrants, and other court-authorized investigative actions.
• Manage multiple investigations and litigation-related responsibilities simultaneously while ensuring timely completion of investigative and court-related assignments.

Peer Support and Education

• Provide technical guidance and investigative assistance to less experienced investigators regarding investigative methods, strategies, procedures, and available resources.
• Share specialized investigative knowledge and experience during case staffing meetings, collaborative investigations, and informal training opportunities.
• Evaluate investigative approaches and provide recommendations to assist colleagues in addressing complex investigative challenges.

Outreach and Education

• Participate in public outreach, informational meetings, and educational presentations to increase awareness of the MFANU's mission and responsibilities.
• Establish and maintain collaborative relationships with local, state, and federal law enforcement and regulatory agencies.
• Provide investigative assistance, technical guidance, and training to law enforcement partners regarding Medicaid fraud and patient abuse or neglect investigations.
• Identify opportunities for interagency collaboration and proactively engage law enforcement partners to support investigations within the MFANU's jurisdiction.
• Develop and tailor educational presentations and outreach materials to meet the needs of various audiences.

Additional Responsibilities - Property and Evidence Management (As Assigned)

• May serve as the MFANU's Property and Evidence Manager, including obtaining and maintaining the required training certification.
• Conduct annual evidence inventories and ensure accurate documentation, secure storage, and preservation of evidence throughout the chain of custody.
• Review and update evidence management policies and procedures to ensure compliance with applicable laws, regulations, and departmental requirements.
• Provide training and guidance to MFANU staff regarding evidence handling, storage, documentation, and updated procedures.
• Coordinate and ensure the proper disposition of evidence in closed matters in accordance with applicable laws and policies.

This recruitment may also be used to fill other Special Agent positions in the Consumer Protection section.
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

WHAT WE ARE LOOKING FOR

Minimum 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.

Experience Only:

• Six (6) years of professional investigative experience as a sworn detective or criminal investigator with a government or law enforcement agency, conducting felony-level criminal investigations. Experience must include serving as the lead investigator in felony criminal cases that resulted in charges being filed in criminal court.
  
  OR

Combination of Education and Experience:

• A combination of directly related education in Criminal Justice, Psychology, Sociology, or a closely related field and professional investigative experience as a sworn detective or criminal investigator with a government or law enforcement agency, totaling six (6) years.
  
  Qualifying investigative experience must include conducting felony-level criminal investigations and serving as the lead investigator in felony criminal cases that resulted in charges being filed in criminal court.

If you are qualifying under the Education and Experience option listed above, you must submit a copy of your transcripts at the time of application. Unofficial transcripts are acceptable.

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 conducting public outreach;
• Certified Fraud Examiner;
• 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 workin