special investigator

Department Of Family And Protective Services

<div><div>The Texas Department of Family and Protective Services (DFPS) works to build on strengths of families and communities to keep children and vulnerable adults safe, so they thrive. We do this through investigations, services, and referrals.</div><div></div><div><b><br>
What You Get Beyond Your Paycheck</b></div><div>
When you join the State of Texas, your monthly paycheck is just one part of your real income. Our benefits provide extra value that many private employers simply don&rsquo;t match&mdash;often adding hundreds of dollars each month to what you take home or save.</div><div></div><div><br>
Here&rsquo;s what you get as a full-time employee:</div><ul><li><b>
100% paid health insurance</b> for you, and 50% paid for eligible family members&mdash;saving you hundreds every month in out-of-pocket medical costs</li><li><b>
Retirement plans</b> with lifetime monthly payments after five years of state service, plus options to save even more with 401(k) and 457 plans</li><li><b>
Paid vacation, holidays, and sick leave</b> so you can recharge and take care of life outside work (that&rsquo;s time off you&rsquo;re actually paid for)</li><li><b>
Optional dental, vision, and life insurance</b>&mdash;at rates much lower than most private plans</li><li><b>
Flexible spending accounts</b> for added tax savings on health and dependent care</li><li><b>
Employee discounts</b> on things like gym memberships, electronics, and entertainment</li></ul><div></div><div><br>
You also might qualify for Public Service Loan Forgiveness, which could help you pay off federal student loans faster.</div><div>
You can see all the details here: ERS recruitment brochure</div><p></p><p><b><br>
Functional Title: </b>CPI Special Investigator Trainee<br>
<b>Job Title: </b>CPI SI Investigator III<br>
<b>Agency: </b>Dept of Family &amp; Protectve Svc<br>
<b>Department: </b>Special Investigations<br>
<b>Posting Number: </b>16814<br>
<b>Closing Date: </b>07/07/2026<br>
<b>Posting Audience: </b>Internal and External<br>
<b>Occupational Category: </b>Protective Services<br>
<b>Salary Range: </b>$4,748.95<b> </b>- $5,921.25<br>
<b>Pay Frequency: </b>Monthly<br>
<b>Salary Group: </b>TEXAS-B-18<br>
<b>Shift: </b>Day<br>
<b>Additional Shift:</b><br>
<b>Telework: </b>Not Eligible for Telework<br>
<b>Travel: </b>Up to 75%<br>
<b>Regular/Temporary: </b>Regular<br>
<b>Full Time/Part Time: </b>Full time<br>
<b>FLSA Exempt/Non-Exempt:</b> Nonexempt<br>
<b>Facility Location:</b>
<br>
<b>Job Location City:</b> FORT WORTH<br>
<b>Job Location Address:</b> 2270 MALL CIR.<br>
<b>Other Locations:</b> Fort Worth; Arlington; Bedford; Hurst; Lake Worth<br>
<b>MOS Codes:</b> 5805,5813,5819,5821,5822,7596,8012,14N,14NX,183X,1D7X1,1N0X1,1S0X1,250X,311A,31A,31B,31D,31PX,351L<br>
351M,35A,35L,35M,3E7X1,3P0X1,43HX,4B0X1,4E0X1,5I0,649X,683X,71SX,749X,783X,89D,89E,EOD,INV,IS,IV,LN<br>
MA,ME,MLES,MSSD,MSSE,MSSR,MST,OAP12,OAP14</p><br>
<div>
CPI Special Investigator Trainee</div><div><br>
</div><div><b>Brief Job Description:</b></div><p>
IMPORTANT NOTICE: This is a specialized position requiring previous experience as a police officer. This is not an entry-level opportunity.<br>
<br>
Professional Background: Only candidates with a solid background in investigative roles within law enforcement will be considered for this position.<br>
<br>
OVERVIEW<br>
Work involves investigating cases that are of a high profile or high-risk and may require a joint investigation with local law enforcement due to alleged criminal acts. Assists the Department of Family and Protective Services (DFPS) Investigation Supervisors by providing consultation and assistance to the investigation of complex cases. Provide forensic investigation techniques and investigation skills. Accompanies DFPS staff on investigations and provides information on criminal statutes, law enforcement procedures, and legal issues when circumstances warrant. Provides feedback to DFPS staff on effective investigation techniques from a law enforcement perspective, may carry a small caseload within the unit, provides training to and serves as a consultant to DFPS staff. Interacts routinely with DFPS staff, supervisors, clients, law enforcement professionals, medical professionals, legal professionals and others involved in the investigative process. Attends civil and criminal court proceedings as required.</p><p>
HELP US MAKE A DIFFERENCE:</p><p>
To explore more of what Investigation Specialists do, click here.</p><div>
For a realistic job preview of this position and to learn more DFPS, please click here. You will also have access to a self-assessment that will help you determine if this type of work is something that is a good fit for you.</div><div></div><div><b><br>
Essential Job Functions (EJFs):</b></div><ul><li>
Conducts specialized investigations of child abuse and neglect, as required by management.</li><li>
Serves as a resource and trainer to DFPS Staff on forensic interview skills and techniques.</li><li>
Identifies and provides for staff development and training needs in the area of forensic child abuse and neglect investigation to achieve and enhance quality performance of unit staff.</li><li>
Provides expert consultation to DFPS staff and the community on complex issues associated with forensic child abuse and neglect investigations.</li><li>
Conducts in-depth interviews to accurately obtain information to determine immediate or long-term risk of abuse or neglect; models advanced interviewing techniques for other workers.</li><li>
Assesses family dynamics and functioning to determine degree and type of agency intervention needed.</li><li>
Prepares and provides sufficient case documentation (including forms and narratives) to provide a complete and accurate record on cases, including legal documentation or testifying in court for all necessary court cases.</li><li>
Reviews cases identified by Child Safety Specialists for specific risk factors or assistance with forensic investigation techniques, in order to ensure staff develop and implement appropriate casework actions and case plans.</li><li>
Attends training and participates in professional development as required by agency and/or supervisor.</li><li>
Performs other duties as assigned and required to maintain unit operations.</li><li>
Promotes and demonstrates appropriate respect for cultural diversity among coworkers and all work-related contacts.</li><li>
Attends work regularly in accordance with agency leave policy.
</li><li>Develops and maintains communication and working relationships within and outside the agency, particularly with professionals associated with law enforcement investigations.</li></ul><div><b>
Knowledge, Skills and Abilities (KSAs):</b></div><div>
Supervisor will determine appropriate knowledge, skills and abilities.</div><br>
<div></div><ul><li>
Knowledge of Texas criminal and civil law relating to abuse and neglect of children.</li><li>
Knowledge of forensic interviewing techniques.</li><li>
Knowledge of normal child development and family dynamics, including problem areas of domestic violence, substance abuse, criminal activity.</li><li>
Knowledge of community resources, particularly within the law enforcement community, and their use for addressing child abuse and neglect problems.</li><li>
Skill in forensic interviewing of children and adults.</li><li>
Skill in determining risk of harm to children.</li><li>
Skill in applying crisis intervention techniques.</li><li>
Skill in investigating and resolving difficult child abuse or neglect cases.<br>
Skill in verbal and written communication.</li><li>
Ability to establish and maintain effective working relationships with employees, agency staff, law enforcement personnel and community stakeholders.</li><li>
Ability to evaluate investigation records in relation to the department standards for quality.</li><li>
Ability to analyze reports and produce comprehensive documents regarding findings.</li><li>
Ability to train staff in forensic interview techniques.</li></ul><div><br>
</div><div><b>Registrations, Licensure Requirements or Certifications:</b></div><p>
Valid Texas Driver's License</p><p>
TCOLE Intermediate License, out of state Peace Officer license, Federal Law Enforcement Officer Certification or Military experience comparable to Texas Peace Officer.</p><p>
Preferred:</p><p>
A current, Licensed Texas Peace Officer or have been a licensed Peace Officer in the State of Texas in the past two years.</p><p>
TCOLE Advance or Master Peace Officer License or equivalent from an out of state law enforcement agency or the United States Military.
</p><div>Out of state law enforcement agency, Federal Law Enforcement Agency or United State Military licenses and certifications comparable to a Texas Peace Officer are acceptable.</div><div><br>
</div><p><b>Initial Criteria:</b></p><ul><li>
Graduation from an accredited high school or equivalent.</li><li>
Five years as a TCOLE Licensed Peace Officer (or comparable out-of-state/military/federal certification).</li></ul><p><b>
OR</b></p><ul><li>
Three years as a TCOLE Licensed Peace Officer (or comparable out-of-state/military/federal certification), <b>AND</b> 2 years&rsquo; experience in DFPS Child Protection Investigations <b>OR</b> completion of DFPS Special Investigator training during previous DFPS employment.</li><li><ul><li>
Experience acquired through military police or military criminal investigative service (e.g., Army MOS 31B/31D, Marine Corps 5811/5821, Navy MA, Air Force 3P0X1/7S0X1, or equivalent) will be considered qualifying experience for all the above criteria, where applicable.</li></ul></li><li><b>
Preferred:</b> 60 hours college credit; 2 years as a Detective/Investigator with multidisciplinary teams on child abuse/neglect or similar. Experience using forensic investigation skills (interviewing suspects, collecting evidence, obtaining statements, report writing).</li></ul><p>
This position may be filled at a CPI Senior Investigator Trainee or a CPI Senior Investigator III. Factors such as education and experience may be considered when determining the classification to be used for hire.</p><p><b>
Additional Information:</b></p><div>
Applicants selected for this position are also eligible to receive a $416.66 monthly increase in addition to the base salary. Applicants hired into an investigative position will receive this increase the first of the month following 120 days of tenure. Once employed, the incumbent must remain in an investigative position to continue to receive the additional pay. If you leave Family Investigations or AR and return within the last 12-months, the INV stipend is given immediately. All other situations must wait the 120 days to receive the INV stipend.</div><div></div><div><b><br>
For APS/CPI/CPS Caseworker positions:
</b></div><p>This role requires frequent travel to homes and offices both within and outside your assigned region. Reliable transportation and a strong willingness to travel are essential, as you can expect to be on the road about 60% of the time. While much of your travel will be local, there will be instances&mdash;including last-minute situations&mdash;where you&rsquo;ll need to go outside your assigned counties, sometimes with little notice. Some overnight travel is also required, especially during initial training held outside your area and as cases demand. Flexibility is critical, as our mission to protect the most vulnerable means you must be ready to serve clients wherever and whenever you are needed.</p><p></p><p><br>
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.</p><p>
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor&rsquo;s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions. You may also contact the DFPS Military Liaison at dfpsmilvets@dfps.texas.gov with additional questions.</p><p>
Applicants selected for hire must pass a background check and if applicable a driver&rsquo;s record check.</p><p>
State of Texas employees are required to maintain the security and integrity of critical infrastructure as defined in Section 117.001(2), State of Texas Business and Commerce Code. Applicants selected for hire comply with this code by completing related training and abiding by agency cybersecurity and communications system usage policies.</p><p>
As a state agency, DFPS is required by Texas Administrative Code (TAC 206 and 213) to ensure all Electronic Information Resources (EIR) follow accessibility standards. The staff must be familiar with the WCAG 2.1 AA and Section 508 to create accessible content including but not limited to; Microsoft Office documents, Adobe PDFs, webpages, software, training guides, video, and audio files.</p><p>
DFPS uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Employees must provide documentation to DFPS to show their identity and authorization to work in the US. Please review the following link for authorized documents: https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents .</p><p>
In compliance with the Americans with Disabilities Act (ADA), HHS/DFPS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS/DFPS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.</p></div>

CPI Special Investigator Trainee

Ethos Risk Services

<div><p><b>ABOUT US:</b></p><p>
Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights that translate into better decision-making for our clients.</p><p></p><p><b><br>
JOB SUMMARY:</b></p><p>
Our dynamic Ethos team is seeking a<b> Special Unit Investigations (SIU) Field Investigator</b> to conduct field investigations, gather and analyze evidence, and produce detailed reports that support claims decisions. You'll work both independently and collaboratively, often traveling to accident scenes, interviewing witnesses, and uploading documentation into our claims system.</p><p></p><p><b><br>
KEY RESPONSIBILITIES:</b></p><ul><li><b>
Scene Investigations:</b> Conduct thorough on-site investigations of accidents and property losses.</li><li><b>
Interviews &amp; Statements:</b> Conduct in-person interviews and obtain accurate, detailed statements from all parties involved.</li><li><b>
Online Research:</b> Gather case information through digital sources and background checks.</li><li><b>
Report Writing:</b> Draft thorough, detailed investigative reports summarizing findings and observations.</li><li><b>
Case Documentation:</b> Conduct in-person interviews and obtain accurate, detailed statements from all parties involved, and retrieve relevant documents to support investigative findings.</li><li><b>
Case Management:</b> Track case progress, time, and expenses accurately within Ethos systems.</li><li><b>
Fraud Detection:</b> Recognize compensability issues, misrepresentation, and other red flags in claims.</li><li><b>
Client Communication:</b> Maintain professional contact with clients and claim handlers throughout the investigation process.</li></ul><p><b><br>
QUALIFICATIONS:</b></p><p><b>
Education:</b> Associate's or Bachelor's degree in Criminal Justice or a related field preferred.</p><p><b>
Experience:</b></p><ul><li>
Minimum of 2 years of SIU experience with an investigative firm or insurance carrier, working across various lines of business such as liability, auto, and property.</li><li>
Former military or law enforcement background preferred.</li></ul><p><b>
Licenses/Certifications:</b></p><ul><li>
Active Private Investigator license or willingness to obtain one (where required by state).</li><li>
Active driver's license and valid auto insurance.</li></ul><p><b>
Other Requirements:</b></p><ul><li>
A well-maintained and reliable vehicle for exclusive use.</li><li>
SIU equipment, including a recorder and a high-quality digital camera.</li><li>
A reliable laptop, cell phone, and internet service are needed for communication and administrative tasks.</li></ul><p><b><br>
WORKING CONDITIONS:</b></p><ul><li>
While we aim to keep assignments within a 2-hour drive of your residence, occasional further travel and overnight stays (covered by the company) may be required.</li><li>
Occasional weekend work may be required to align with case demands and or/client requests.</li></ul><p><br>
Ethos Risk Services is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic.</p></div>

Special Investigations Unit (SIU) - Field Investigator

L.A. Care Health Plan

<div></div><div><div><div><div><div><div><div><p>Special Investigation Unit Investigator III
</p></div></div></div></div><div><div><div><div><b>Job Category: </b>Administrative, HR, Business Professionals
</div></div></div></div><div><div><div><div><b>Department: </b>Special Investigations Unit
</div></div></div></div><div><div><div><div><b>Location:
</b>Los Angeles, CA, US, 90017
</div></div></div></div><div><div><div><div><b>Position Type: </b>Full Time
</div></div></div></div><div><div><div><div><b>Requisition ID: </b>13060
</div></div></div></div><div><div><div><div><div><b>Salary Range:</b> $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)</div><br>
<div></div>
<div>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation&rsquo;s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br>
<br>
Mission: L.A. Care&rsquo;s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br>
</div><div><div><div><div>Job Summary</div>
</div><div><p>
The Special Investigation Unit Investigator III performs in-depth evaluation of potential fraud &amp; abuse cases and develops complex investigations that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for fraud, waste &amp; abuse. In addition, this position is responsible for building the investigative approach and provide leadership for Investigators through mentoring, on-site audit leadership and hands-on training of investigative techniques.</p><br>
<p></p>
<div>Responsible for in-depth investigations requiring subject matter expertise for suspected provider, pharmacy, employer or member fraud or abuse across all products at L.A. Care Health Plan. Ensures adherence to L.A. Care's policies and procedures for its various product offerings. Conducts investigation-related training. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.</div>
</div></div><div><div><div>
Duties</div>
</div><div><p>
Investigates allegations and complex issues pertaining to potential health care fraud by providers or members. Makes potential fraud &amp; abuse determinations by utilizing a variety of sources including data analytics to detect unusual billing. Proactively seeks out and develops leads received from fraud tips and any variety of sources (e.g., fraud alerts, media) and initiates appropriate action. Writes comprehensive investigatory/fact-finding reports and summaries documenting interviews and findings. Reviews information contained in standard claims processing system files (e.g. claims history, provider files) to determine provider billing patterns and detect potential fraudulent or abusive billing practices or vulnerabilities in Medi-Cal/Medicare policies and initiates appropriate action. This position is a leader at onsite audits as assigned in conjunction with investigation development. Completes investigations after referrals to law enforcement (Department of Health Care Services (DHCS), Centers for Medicare &amp; Medicaid Services (CMS), Department of Justice (DOJ) or local police). Participates at hearings/appeals and can testify as a witness in court proceedings. Initiates the process with L.A. Care&rsquo;s Recovery Services for recoupment of overpaid monies.</p><br>
<p></p>
<p>Submits referrals of suspected fraud cases within mandated period of time as required by DHCS and CMS. Prepares and submits investigative report documenting all phases of an investigation. Compiles and maintains various documentation and other reporting requirements while following all confidentiality and security guidelines. Maintains cases referred to law enforcement and responds to requests for information; pursues applicable administrative actions during investigation/case development.</p><br>
<p></p><div>Participates in industry meetings/trainings and is able to effectively share and gather significant information. Develops and maintains strong working relationships with associates and regulators including DHCS, DOJ the FBI, Local Law Enforcement, Prosecutors, etc. Continually enhances investigative skills and understanding of emerging issues and trends impacting the industry.</div><br>
<div></div><p>Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project&rsquo;s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.</p><br>
<div></div>
<div>Perform other duties as assigned.</div>
</div></div><div><div><div>
Duties Continued</div>
</div></div><div></div><div><div><div>Education Required</div>
</div><div><div>Bachelor's Degree in Criminal Justice or Related Field</div><div>
In lieu of degree, equivalent education and/or experience may be considered.</div></div></div><div><div><div>
Education Preferred</div>
</div><div><div>Master's Degree in Criminal Justice or Related Field</div></div></div><div><div><div>
Experience</div>
</div><div><div><b>
Required:</b></div>
<p>Minimum of 5 years of experience in healthcare fraud investigation/detection and/or healthcare related specialty including but not limited to; Pharmacy, DME, Mental Health, Behavioral Health, Hospice, Home Health, Dental etc.</p>
<p>Experience conducting fact-finding interviews or investigations to gather information and draw conclusions from various accounts and versions of the same event.</p><br>
<p></p>
<p>Experience managing large amounts of data including pivot tables, complex calculations, and ability to perform comparisons across multiple large data sets</p><br>
<p></p>
<p><b>Preferred:
</b></p><div>Diverse experience as subject matter expert (SME) with multiple specialties including: Pharmacy, DME, Mental Health, Behavioral Health, Hospice, Home Health, Dental etc.</div>
</div></div><div><div><div>
Skills</div></div><div><div><br>
<b>Required:</b><br>
Excellent research skills and the ability to support conclusions with documentary evidence.</div><br>
<div></div>
<div>Excellent analytical, problem solving, and resolution skills and the ability to discern the practical application of regulatory and legal requirements.</div><br>
<div></div>
<div>Demonstrated strong organizational skills and the ability to manage multiple demands and priorities.</div><br>
<div></div>
<div>Excellent and effective communication skills, both verbal and written.</div><br>
<div></div>
<div>Proficient computer skills, including computer applications such as MS Word and Excel.</div><br>
<div></div>
<div>Understanding of the vital importance of commitment to excellence and demonstrating a high regard for organizational values.</div><br>
<div></div>
<div>Ability to maintain in-depth working knowledge of fraud investigation techniques and mentor less experienced team members.</div><br>
<div></div>
<div><b>Preferred:
</b></div><div>Proficiency with Access.</div>
</div></div><div><div><div>
Licenses/Certifications Required</div>
</div></div><div></div><div><div><div>Licenses/Certifications Preferred</div>
</div><div><div>Accredited Health Care Fraud Investigator (AHFI)</div><div>
Certified Fraud Examiner (CFE)</div><div>
Certified Professional Coder (CPC) designation by the American Academy of Professional Coders</div></div></div><div><div><div>
Required Training</div>
</div></div><div></div><div><div><div>Physical Requirements</div>
</div><div><div>Light</div></div></div><div><div><div>
Additional Information</div>
</div></div></div><div></div><div><b>
Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.</div><br>
<div></div>
<div><b>L.A. Care offers a wide range of benefits including</b></div>
<ul><li>Paid Time Off (PTO)</li>
<li>Tuition Reimbursement</li>
<li>Retirement Plans</li>
<li>Medical, Dental and Vision</li>
<li>Wellness Program</li>
<li>Volunteer Time Off (VTO)</li></ul><div><br>
</div></div></div></div></div><p><br>
<b>Nearest Major Market: </b>Los Angeles
<br>
<b>Job Segment: </b>Medical Coding, Pharmacy, Behavioral Health, Clinic, Hospice, Healthcare</p></div></div></div><div></div>

Special Investigation Unit Investigator III

Hennepin County

<div><div><div><h2 class="jobSectionHeader"><b>Description</b></h2></div>
<p></p><div><div>Hennepin Health is seeking a Senior Investigator for the Special Investigations Unit (SIU). This Senior Investigator will be responsible for managing a comprehensive program to combat suspected fraud, waste, and abuse (FWA) and leading FWA investigations from triage to conclusion.</div><p><br>
Current Hennepin County employees who refer a candidate hired into an open competitive position may be eligible for a <b>$500 </b>referral bonus. For more information visit employee referral program.</p><br>
Find us <b>here</b> at upcoming career fairs!<div></div><div><b><br>
Location and hours:</b></div>
This position is hybrid and will be performed both on-site at the Health Services Building at 525 Portland Avenue, Minneapolis, MN 55415 (this location is accessible by public transportation and light rail) and remote as job duties require. Work hours will be Monday through Friday, 8 a.m. - 4:30 p.m. with Wednesday and Thursday being onsite. While this position is designated as hybrid, based on current requirements hires must reside in or relocate to Minnesota or Wisconsin. New Employee Orientation (NEO) for all new benefit-earning employees is in-person in downtown Minneapolis. Details about NEO will be provided upon hire.<br>
<br>
<b>About the position type:</b><br>
This is a full-time, benefit-earning position.<br>
This position is internally classified as an Administrative Assistant, Senior.<br>
Click here to view the job classification specification.<br>
<div><b>
In this position, you will:</b></div><ul><li>
Lead research and identify potential areas of fraud, waste, and abuse (FWA) and request data to facilitate investigations, including the creation and utilization of analytic reports.</li><li>
Manage investigations from identification and triage until completion, making recommendations on final disposition of cases.</li><li>
Work with other department of Hennepin Health to effectuate case dispositions (e.g., implement payment suspensions, make policy updates, provider outreach, etc.).</li><li>
Collaborate with the investigation departments of our vendors, and other partners in the county, state, and federal government.</li><li>
Create regular reports for Hennepin Health&rsquo;s Board and regulators.</li><li>
Perform as the subject matter expert on areas related to FWA.</li><li>
Manage existing policy and procedure documents related to FWA investigations.</li></ul><b>
Need to have:</b><ul><li>
One of the following:<ul><li>
Bachelor's degree or higher in public administration, business administration, criminal justice, health care administration, or other field appropriate to the position <b>and</b> four or more years of experience in general administrative work relating to the management of departmental/organizational operations or in a specialty area appropriate to the position.</li><li>
Eight years or more of general administrative work related to the management of departmental/organizational operations or in a specialty area appropriate to the position.</li></ul></li></ul><div><b><br>
Nice to have:</b></div><ul><li>
Certified Fraud Examiner (CFE) credential or Accredited Health Care Fraud Investigator (AHFI) designation.</li><li>
Experience working with:<ul><li>
Medicaid, MinnesotaCare, Medicare, or other publicly funded health programs.</li><li>
Healthcare fraud investigations.</li><li>
Claims or claims processing, including knowledge of medical terminology, costs, enrollment, and group data.</li><li>
A managed care organization.</li><li>
Microsoft Office Suite (Excel, Word, OneNote, Teams, Outlook), Google Sheets, and industry claims platforms (e.g. Facets).</li></ul></li><li>
Knowledge of state and federal laws and regulations pertaining to health insurance and/or government programs, including Medicare and/or Medicaid.</li><li>
Ability to:<ul><li>
Request, use, and analyze data to perform investigations.</li><li>
Have excellent verbal and written communication skills.</li></ul></li></ul><br>
<b>
About the department:</b><br>
Hennepin Health provides health care coverage to Hennepin County residents who are enrolled in a Minnesota Health Care Program. Hennepin Health is a nonprofit, state-certified health maintenance organization that contracts with the Minnesota Department of Human Services. We envision being a leader in partnering with our members and communities to improve health, by integrating health care and service to enhance the health and well-being of our members and the community.<br>
<br>
<b>About Hennepin County:</b><br>
Hennepin is the largest county government organization in Minnesota. Our employees work every day to improve the health, safety and quality of life for our residents and communities. All of our jobs align with our mission to serve residents through transformative services that eliminate disparities, eliminate inequities, and create opportunity for all and our vision of a community where all people are healthy, all people are valued, and all people thrive.<br>
<br>
Our employees receive a combination of competitive benefits and positive workplace culture not found at other organizations. This includes meaningful work that impacts our community, competitive pay, work-life balance, a variety of benefits and opportunities to grow. Learn more at The Bridge (login as Guest).<br>
<br>
Hennepin County envisions an organization where our commitment to diversity and the elimination of disparities is fundamental in providing excellent service to our community.<br>
<br>
Your future. Made here.<br>
<br>
This posting may be used to fill current and future vacancies.<br>
<br>
<b>Watch this </b><b>video</b><b> for application best practices and tips.</b><br>
<br>
This position will have access to systems or other documentation that contains HIPAA data.<br>
<br>
Invitations to interview will be based upon an assessment of education and experience. Final candidates may be required to complete a background check.<br>
<br>
<b>If you have any questions, please contact:</b><br>
Kristin Checco<br>
Kristin.Checco@hennepin.us</div></div></div><p></p>

Senior Investigator - Special Investigations Unit (SIU)

Cook County, IL

<div></div><div><div><p>The Office of the Independent Inspector General (OIIG) was created to detect, deter and prevent corruption, fraud, waste, mismanagement, unlawful political discrimination or misconduct in the operation of Cook County Government. Cook County, Ill., Ordinances 07-O-52 (2007). Conducts investigations primarily in connection with reported incidents of improprieties. Prepares confidential reports of a complex nature and makes recommendations to other senior level staff. May establish and maintain advisory and liaison contacts with officials in federal, state and municipal Governments, including the Federal Bureau of Investigation, United States Secret Service, Illinois Attorney General's Office, Cook County State's Attorney's Office, and the United States Attorney&rsquo;s Office. Consults with the OIIG Supervising Investigator and other senior level staff. May supervise OIIG Investigators and other support staff as required. This position may also involve a concentration focusing on investigation, compliance, oversight, auditing and monitoring of government compliance with the terms of the orders entered in the Shakman v. Cook County prohibiting unlawful political discrimination.</p><div></div><div><b><br>
This position is Actively Recruited and at will.</b></div></div><div></div><div><div><br>
 <b>Minimum Qualifications</b></div><div><ul><li>
Graduation from an accredited college or university with a Bachelor&rsquo;s degree <b>is required.</b></li><li><p>
Six (6) years of full-time work experience in the conduct of investigations involving criminal or fraudulent activity, audits, administrative violations or other matters of potential civil liability<b> is required</b>.</p></li></ul><p></p><p><b><br>
 -OR-</b></p><ul><li><p>
 Six (6) years of full-time work experience practicing law in the fields of civil or criminal litigation.</p></li></ul></div><div><b>
Knowledge, Skills, Abilities and Other Characteristics</b></div><div><ul><li>
Knowledge of rules, regulations and operating procedures as they pertain to investigating reported incidents of improprieties at all levels of government.</li><li>
Knowledge of applicable laws and regulations of state, local and other authorities relative to reported cases of fraud and waste of governmental assets.</li><li>
Skill in performing in-depth, confidential and sensitive investigations as it pertains to reported incidents of improprieties involving all levels.</li><li>
General knowledge of the legal process as it pertains to the prosecution of criminal cases and any court proceedings which may take place.</li><li>
Ability to provide testimony in court in an accurate and informed manner.</li><li>
Knowledge of the rules of evidence relating to investigations and testimony.</li><li>
Skill and ability to obtain and organize facts and information from others.</li><li>
Self-motivated, in addition to working well with others.</li><li>
Public speaking and leadership skills necessary to articulate issues and concerns regarding confidential issues of investigations and other improprieties.</li><li>
Skill in the use of Microsoft Office Suite with emphasis on Word and Excel.<br>
</li></ul></div><div>
 <b>Physical Requirements</b></div><div><b>
</b></div><div><b>
Sedentary Work</b></div><div>
Sedentary Work involves exerting up to 10 pounds of force occasionally or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time.</div><div><b><br>
</b></div><div><b>
The duties listed are not set forth for purposes of limiting the assignment of work. They are not to be construed as a complete list of the many duties normally to be performed under a job title or those to be performed temporarily outside an employee's normal line of work.</b></div><div></div><p><b><br>
Group and Voluntary Benefits Offered:</b></p><ul><li><p>
Medical, Dental, and Vision</p></li><li><p>
Basic Term Life Insurance</p></li><li><p>
Pension Plan</p></li><li><p>
Deferred Compensation Program</p></li><li><p>
Employee Assistance Program</p></li><li><p>
Paid Holidays, Vacation, and Sick Time</p></li><li><p>
Voluntary Benefits</p></li><li><p>
You May Qualify for the Public Service Loan Forgiveness Program (PSLF)</p></li><p></p><li><p><br>
For eligible employees the County has a hybrid work environment which allows employees telecommuting and flexible scheduling options.</p></li></ul><p></p><p><b><br>
Salary: </b>$107,058/ Yearly</p><div></div><div><div><p><br>
The County has a hybrid work environment which allows employees telecommuting and flexible scheduling options.</p></div></div><div><ul><li><b>This position requires successful completion of post-offer tests, which may include a background check, drug screen and medical examination.</b></li></ul><p></p><p><b><br>
Please contact</b><b> </b><b>BHR.WorkforceStrategy@cookcountyil.gov</b><b> </b><b>for inquiries about this position.</b></p><p></p><ul><li><br>
<b>Must be legally authorized to work in the United States without sponsorship.</b></li></ul><p></p><p><br>
Falsification of any information in the application process will result in disqualification, dismissal after hire, and/or placement on the County&rsquo;s Ineligible for Rehire List for a period of two (2) or five (5) years. For current County employees, such falsification may result in discipline, up to and including termination, and placement on the County&rsquo;s Ineligible for Rehire List for a period of two (2) or five (5) years. <i>See</i> Cook County Code of Ordinances, Article II, Sections 44-54 <i>Unlawful Practices Relating to Employees and Employment - Penalty</i>, 44-56 <i>Political Discrimination</i>; OIIG Employment Plan, Section V.N. <i>Pre-Interview License and Certification Verification</i>; Supplemental Policy No. 2014-2.13 <i>Ineligible for Rehire List</i>; and Cook County Personnel Rules 3.3(b) (7) (d).</p><p><b>
EEO Statement</b></p><p>
Cook County Government is an Equal Employment Opportunity (&ldquo;EEO&rdquo;) employer. Cook County prohibits illegal discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to race, color, sex, age, religion, disability, national origin, ancestry, sexual orientation, marital status, parental status, source of income, housing status, military service or discharge status, gender identity, genetic information, or any other protected category established by law, statute or ordinance as further defined in Chapter 44. Human Resources, Article II. Personnel Polices, Section 44-53 of the Cook County Code of Ordinances and Chapter 42. Human Relations, Article II. Human Rights, Section 42-35 of the Cook County Code of Ordinances.</p><p></p><p><b><br>
Social Media Disclaimer</b></p><p>
The County&rsquo;s hiring process is governed by the OIIG Employment Plan which prohibits employment actions from being influenced by any Political Reasons or Factors for Non-Exempt Positions. The advertisement of this position by any individual does not constitute an offer or promise of</p><p><b>
COOK COUNTY IS AN EQUAL OPPORTUNITY EMPLOYER</b></p></div></div></div><div></div>

OIIG SENIOR INVESTIGATOR - THE OFFICE OF THE INDEPENDENT INSPECTOR GENERAL (ACTIVELY RECRUITED)

Allied Universal Compliance and Investigations

<div><p>SIU Investigator - Tampa Bay Area</p><h2 class="jobSectionHeader"><b>
Overview</b></h2><p>
Company Overview:
</p><p>Advance Your Career in Insurance Claims with Allied Universal&reg; Compliance and Investigation Services. Allied Universal&reg; Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.</p><h2 class="jobSectionHeader"><b>
Job Description</b></h2><p>
Allied Universal&reg; is hiring a Special Investigations Unit (SIU) Investigator. Special Investigations Unit (SIU) Specialists investigate claims with red flags that suggest fraudulent behavior In relation to an Insurance claim. The SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for prosecution.</p><p><br>
</p><ul><li><b>Must possess a valid driver's license with at least one year of driving experience</b></li><li><b>
Florida applicants must either hold a C Private Investigators' License or independently complete the 40-hour course necessary to successfully apply for a CC Private Investigator's license (apprenticeship) before applying</b></li></ul><br>
<p></p>
<p><b>RESPONSIBILITIES:</b>
</p><ul><li>Independently investigate suspected fraudulent insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability</li>
<li>Acquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance</li>
<li>Create and maintain detailed documentation for investigations, file reviews, audits, training tasks, consulting projects, and other assignments as directed</li>
<li>Produce professional and expert reports, memos, and letters that are clear, concise, and grammatically correct</li>
<li>Run appropriate database indices if necessary and verify the accuracy of results found</li>
<li>Independently develop a strategic plan to achieve assignment objectives, ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor</li></ul><p><b>
QUALIFICATIONS (MUST HAVE):</b>
</p><ul><li>Must possess one or more of the following:</li><li><ul><li>
Bachelor's degree in Criminal Justice</li>
<li>High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud</li></ul></li><li>
Ability to be properly licensed as a Private Investigator as required by the state where work Is completed</li>
<li>Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course</li>
<li>Minimum of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims</li>
<li>Proficient understanding and application of anti-fraud laws, insurance regulations, and compliance standards within their home state and designated regional area.</li>
<li>Proficient in utilizing laptop computers and cell phones.</li>
<li>Special Investigative Unit (SIU) Compliance knowledge</li>
<li>Ability to type 40+ words per minute with minimum error</li>
<li>Flexibility to work varied and irregular hours and days including weekends and holidays</li></ul><p><b>
PREFERRED QUALIFICATIONS (NICE TO HAVE):</b>
</p><ul><li>Military experience</li>
<li>Law enforcement</li>
<li>Insurance administration experience</li>
<li>Familiarity with California SIU regulations</li>
<li>One or more of the following professional industry certifications:</li><li><ul><li>
Certified Fraud Investigator (CFE)</li>
<li>Certified Insurance Fraud Investigator (CIFI)</li>
<li>Fraud Claim Law Associate (FCLA)</li>
<li>Fraud Claim Law Specialist (FCLS)</li>
<li>Certified Protection Professional (CPP)</li>
<li>Associate in Claims (AIC)</li>
<li>Chartered Property Casualty Underwriter (CPCU)</li></ul></li></ul><p><b>
BENEFITS:</b>
</p><ul><li>Medical, dental, vision, basic life, AD&amp;D, retirement plan and disability insurance</li>
<li>Seven paid holidays annually, sick days available where required by law</li>
<li>Vacation time offered at an initial accrual rate of 3.08 hours biweekly; unused vacation is only paid out where required by law</li></ul><h2 class="jobSectionHeader"><b>
Closing</b></h2><p>
Allied Universal&reg; is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com
</p><p>If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.</p><h2 class="jobSectionHeader"><b>
Requisition ID</b></h2><br>
2026-1579822</div>

SIU Investigator - Tampa Bay Area

Lemieux & Associates

<div>
 Come grow with us! Lemieux &amp; Associates, a national leader in the investigative industry, is seeking experienced Field Investigators in the Brooklyn, NY or surrounding area. This is a part-time position for the right individual. The owners are entrepreneurial, experienced field investigators, each with over 25 years of experience. We understand the job and never forgot our roots in the field. We are dedicated professionals with a motivational management style with proven ability to recruit, develop and direct highly successful teams that consistently excel.
 <br/>
 <br/>
 <strong>
  You must have surveillance experience as a Private Investigator, SIU/Claims investigation experience and reside in the Buffalo or surrounding area. Please submit your resume and complete the questionnaire. If you do not complete the questionnaire, your resume will not be accepted.
  <br/>
  <br/>
 </strong>
 <strong>
  Job Classification: Non-Exempt
  <br/>
  <br/>
 </strong>
 <strong>
  Position Summary
  <br/>
  <br/>
 </strong>
 A part-time investigator familiar with New York State Insurance Fund surveillance &amp; SIU/Claims investigations is needed to cover the Buffalo and surrounding area. Applicants must be timely with follow-up and have experience conducting surveillance &amp; SIU/Claims investigation specifically for NYSIF. The investigator must also be familiar with NYSIF protocols and be able to follow all directives and policies in place.
 <br/>
 <br/>
 Note: If an applicant is currently on another agencies NYSIF Personnel Spreadsheet, they must be removed prior to employment with Lemieux &amp; Associates as a NYSIF investigator.
 <br/>
 <br/>
 <strong>
  Essential Job Functions
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Conducting surveillance assignments within investigation parameters and special instructions
  </li>
  <li>
   Conducting PDFR's (Alive and Well checks), Beneficiary Field Reviews, Claimant/Employer Interviews, and Forms assignments.
  </li>
  <li>
   The investigator must also be familiar with NYS WCB forms and be able to determine whether the acquired forms are acceptable for submission to the WCB by the client.
  </li>
  <li>
   Investigators are expected to be able to discreetly determine information such as the subject's identity, whereabouts, and any other investigative procedures that may include direct contact as the investigation warrants.
  </li>
  <li>
   Surveillance typically is conducted in four-hour blocks but is subject to change, with multiple blocks worked per day.
  </li>
  <li>
   The investigator is also expected to follow procedures and protocols laid out by Lemieux &amp; Associates as well as the client.
  </li>
  <li>
   Testifies to the facts collected in any hearing or court of law.
  </li>
  <li>
   Other assignments and projects as dictated by business need or management direction.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Required Skills And Abilities
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Working Knowledge of Windows, Microsoft Office, Internet Explorer, and Adobe Acrobat
  </li>
  <li>
   Effective written communication skills and report writing
  </li>
  <li>
   Strong organizational and time management skills
  </li>
  <li>
   Demonstrated strong interpersonal communication skills and the ability to effectively build rapport
  </li>
  <li>
   Ability to make timely phone calls as necessary to facilitate an interview
  </li>
  <li>
   Ability to conduct interviews with employers and claimants thoroughly while following procedures and protocols laid out by Lemieux &amp; Associates as well as the client
  </li>
  <li>
   Flexibility to work varied/irregular hours and days including holidays and weekends
  </li>
  <li>
   Able to work well independently
  </li>
  <li>
   Able to travel extensively throughout assigned territory and effectively manage expenses
  </li>
  <li>
   Possess a reliable vehicle, digital camera and computer with Windows Operating
  </li>
  <li>
   Possess a valid state-issued driver's license
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Qualifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Experience conducting surveillance as a private investigator is a must
  </li>
  <li>
   Bi-lingual is a plus
  </li>
  <li>
   Possess a valid state-issued driver's license
  </li>
  <li>
   Possess a reliable vehicle, digital camera and computer with Windows Operating System, Microsoft Word and Internet connection
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Physical Demands And Work Environment
  <br/>
  <br/>
 </strong>
 While performing the duties of this job, the employee is typically in the community. The employee is regularly required to spend long periods of time in an automobile or other location for surveillance purposes. Regularly operates a video camera, computer, and cellular telephone. Communicates on a regular basis with supervisors, clients, and staff via telephone and email. The noise level in the work environment is usually moderate.
 <br/>
 <br/>
 Salary: $25 - $30 per hour
</div>


Buffalo, NY NYSIF Surveillance & SIU Investigator

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