Investigator, Medicaid Fraud Control Unit

DHRM is hiring a full-time Investigator for its Medicaid Fraud Control Unit in Virginia Beach, Virginia Beach City. This investigative role offers the opportunity to protect the integrity of Virginia's Medicaid program and safeguard public resources through rigorous, methodical investigation of suspected provider fraud, waste, and abuse.

About the Role

As an Investigator with the Medicaid Fraud Control Unit, you will conduct complex, multi-faceted investigations into health care providers suspected of defrauding or abusing the Virginia Medicaid Program. This position is based in the Virginia Beach regional office and requires field investigations, document analysis, witness interviews, and close collaboration with law enforcement and legal professionals to build cases for prosecution and administrative action.

What You'll Do

• Launch and manage complex investigations into Medicaid provider fraud and abuse allegations
• Conduct field investigations, including facility visits and on-site examinations to gather evidence
• Interview witnesses, beneficiaries, and health care providers to establish facts and gather testimony
• Analyze financial records, billing data, and Medicaid claims to identify fraudulent patterns and schemes
• Prepare detailed investigative reports and case documentation for prosecution and administrative review
• Coordinate with law enforcement partners, prosecutors, and agency leadership on investigation strategy
• Testify in administrative hearings or legal proceedings when cases proceed to adjudication
• Maintain thorough documentation and evidence protocols throughout the investigation lifecycle

What We're Looking For

• Proven experience in investigation, law enforcement, fraud detection, or related field work
• Strong analytical and critical-thinking skills to evaluate complex financial and medical records
• Excellent written and verbal communication skills, including professional report writing
• Ability to work independently and manage multiple investigations simultaneously
• Valid Virginia driver's license and willingness to travel within the region
• Eligibility to undergo background investigation and maintain security clearance
• Knowledge of health care systems, Medicaid operations, or fraud investigation preferred but not required

About DHRM

DHRM operates the Medicaid Fraud Control Unit on behalf of Virginia's Attorney General and Department of Law. The Unit investigates allegations of provider fraud and abuse within Virginia's Medicaid program, protecting vulnerable beneficiaries and preserving state resources. Investigators serve a critical role in holding health care providers accountable and maintaining program integrity.

How to Apply

To apply, complete your application directly on this page, or you'll be redirected to the employer's application platform to finish submitting there.