Top 159 Investigator Jobs in Edina, Mn

Medical Review Associate Investigator
HealthPartners/GHI —Bloomington, MN
- $29.57 - $44.35 an hour
- Full-time
- Hybrid work
- Word processing
- Research
- Mid-level
- Health insurance
Medical Review Investigator
HealthPartners/GHI —Bloomington, MN
- $29.57 - $44.35 an hour
- Full-time
- Hybrid work
- Word processing
- Research
- Mid-level
- Health insurance
Surveillance Agent
MARSHALL INVESTIGATIVE GROUP LLC —Minneapolis, MN
- $22 - $32 an hour
- Part-time
- Microsoft Word
- 11+ years
- Research
Quick Apply
Security Investigator
Pinkerton —Minneapolis, MN
- Full-time
- CPR Certification
- Computer literacy
- First Aid Certification
Investigator
State of Minnesota Board of Public Defense —Saint Paul, MN
- $68,821 - $112,053 a year
- Full-time
- Writing skills
- Mid-level
- Office
- Commuter assistance
- Paid parental leave
6d
Surveillance Investigator
Frasco Inc —Minneapolis, MN
- $20 - $26 an hour
- Part-time
- Clean driving record
- Military
- Writing skills
- Paid training
- Mileage reimbursement
Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Saint Paul, MN
- $43,888 - $93,574 a year
- Full-time
- Microsoft Word
- Spanish
- Microsoft Excel
- Health insurance
- Dental insurance
Human Rights Investigator I
City of St. Paul —Saint Paul, MN
- $73,944 - $105,976 a year
- Online Application
- Background check
- Mid-level
- Master's degree
- Commuter assistance
- AD&D insurance
3d
Clinical Contracts Analyst (REMOTE)
Teleflex —Minneapolis, MN
- $79,400 - $119,100 a year
- Remote
- Microsoft Excel
- 5 years
- Bachelor of Science
- Disability insurance
- Health insurance
Clinical Research Coordinator I
Thermo Fisher Scientific —Richfield, MN
- $25 - $28 an hour
- Full-time
- BLS Certification
- Office
- Bachelor's degree
- Commuter assistance
- Paid parental leave
6d
Senior Medical Science Liaison, Upper Midwest
BioNTech AG —Minneapolis, MN
- $146,300 - $234,100 a year
- Full-time
- Background check
- Medicine
- Microsoft Office
- Health savings account
- AD&D insurance
Surveillance Investigator
Allied Universal® Compliance and Investigations —Minneapolis, MN
- $25 - $30 an hour
- Weekends as needed
- Microsoft Word
- Military
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
8d
Human Rights Investigator - Investigation Specialist 2
State of Minnesota - Human Rights Dept —Saint Paul, MN
- $31.81 - $46.96 an hour
- Multiple hires
- Hybrid work
- Doctoral degree
- Writing skills
- Mid-level
- Paid parental leave
- Paid holidays
10d
Organized Retail Crime Specialist
KOHLS —Roseville, MN
- $25.50 - $40.80 an hour
- Weekends as needed
- Writing skills
- Mid-level
- High school diploma or GED
- Disability insurance
- Dental insurance
Clinical Research Coordinator
MNGI Digestive Health —Minneapolis, MN
- $60,153.60 - $69,180.80 a year
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- Clinic
- Profit sharing
- Paid holidays
Quick Apply
Medical Science Liaison Immunology - Admilparant (MT, MN, SD, ND, NE, WY)
Bristol-Myers Squibb —Minneapolis, MN
- $166,090 - $201,262 a year
- Email
- Hybrid work
- Medicine
- English
- Mid-level
- Paid holidays
- Disability insurance
Clinical Research Coordinator
CENTER FOR VETERANS RESEARCH AND EDUCATION —Minneapolis, MN
- $48,000 - $75,000 a year
- Weekends as needed
- Background check
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Part Time SIU Investigator
The Robison Group —Minneapolis, MN
- $30 - $35 an hour
- Part-time
- Background check
- 5 years
- Computer literacy
Quick Apply
Senior AML Analyst – Surveillance & Investigations
Royal Bank of Canada —Minneapolis, MN
- $70,000 - $130,000 a year
- Full-time
- 5 years
- Research
- Office
- Disability insurance
- Health insurance
Surveillance Investigator
Advantage Surveillance LLC —Minneapolis, MN
- $20 - $25 an hour
- Weekends as needed
- Clean driving record
- Pass drug screening
- Driving
- Travel reimbursement
- Paid parental leave
Quick Apply

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Medical Review Associate Investigator

HealthPartners/GHI -
Bloomington, MN

Apply Now

Job Details

Full-time
$29.57 - $44.35 an hour

Benefits

Health insurance

Qualifications

Stakeholder engagement
Word processing
Spreadsheets
Research
Productivity software
Stakeholder relationship building
Stakeholder management

Full Job Description

JOB DESCRIPTION

HealthPartners is hiring a Medical Review Associate Investigator. The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and supports the identification, assessment, and preliminary analysis of potential Fraud, Waste, and Abuse (FWA) concerns across Medicaid, Medicare, and Commercial (fully insured and self‑funded) lines of business. This role applies analytical judgement and discretion to evaluate allegations, triage incoming referrals, assess risk indicators, and support investigative decision making under the guidance of senior SIU staff.

Primary responsibilities include performing structured intake analysis, conducting preliminary review of claims and provider data, assessing documentation and medical record completeness, identifying investigative risks or trends, and supporting prioritization of cases based on defined FWA indicators.

This position is a professional, developmental role designed to build investigative competencies and provide exposure to investigative workflows, medical record handling, claims documentation practices, and regulatory process tracking. Successful performance may support progression into SIU investigative roles, subject to business need, demonstrated competencies, and meeting minimum qualifications for the Investigator position.

MINIMUM QUALIFICATIONS:

Education, Experience or Equivalent Combination:
- Associate degree in healthcare administration, business, criminal justice, or related field OR equivalent relevant work experience.
- 2–3 years of experience in healthcare investigations, medical review, audits/compliance, or payment integrity, or related work requiring strong attention to detail.
Knowledge, Skills, and Abilities:
- Proficient in using personal computers, word processing, and spreadsheets.
- Strong communication and stakeholder management skills.
- Proficient in drafting detailed and accurate written reports.
- Excellent presentation, planning and organizational skills.
- Strong analytical skills with the ability to assess complex situations and identify effective solutions.

PREFERRED QUALIFICATIONS:

Education, Experience or Equivalent Combination:
- 2 years’ experience in medical fraud, waste, and abuse (FWA) investigations.
Licensure/ Registration/ Certification:
- Professional certification as a Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), Accredited Healthcare Fraud Investigator (AHFI), or similar.
Knowledge, Skills, and Abilities:
- Understanding of the current FWA landscape and trends with the ability to adapt to shifting priorities and evolving requirements.
- Demonstrated familiarity with CPT codes and terminology.
- Experienced in using data analysis to uncover trends and patterns.

ESSENTIAL DUTIES:

60% – Investigative Analysis, Case Support & Risk Assessment

Assists with full lifecycle Fraud, Waste, and Abuse (FWA) investigations by performing preliminary fact finding, issue identification, and analytical review under the guidance of an SIU Investigator.
Reviews and analyzes claims data, billing patterns, and available medical documentation to identify inconsistencies, risk indicators, and potential FWA schemes.
Applies investigative criteria, policies, and professional judgment to evaluate allegations, assess case complexity, and support case prioritization.
Identifies documentation gaps, develops investigative observations, and recommends next steps to advance investigative review.
Documents analytical findings, summaries, and risk considerations in the case management system to support investigator determinations.

15% – Prepayment, Monitoring & Pattern Detection Support

Supports prepayment and concurrent review activities through analysis of claims and records prior to payment.
Assists with identifying trends, anomalies, or emerging patterns indicative of potential FWA across providers, services, or claim types.
Summarizes findings and escalates identified risks to SIU Investigators or leaders for further investigation or intervention.

15% – Investigative Documentation, Reporting & Regulatory Coordination
- Prepares investigative summaries, timelines, and documentation analyses that contribute to formal investigative reporting and regulatory decision making.
- Reviews records for accuracy, relevance, and consistency with investigative hypotheses, flagging discrepancies or concerns.
- Supports coordination related to regulatory or oversight notifications (e.g., DHS, OIG) by interpreting requirements, assessing investigative impact, and ensuring appropriate internal routing, without independently issuing determinations or referrals.
10% – Investigative Development, Operational Insight & Continuous Improvement

Participates in structured training and applied learning related to investigative techniques, medical record review, claims analysis, and FWA typologies.
Identifies recurring investigative challenges, documentation issues, or workflow inefficiencies and recommends process or control improvements.
Contributes to operational tracking and internal reporting through analytical review and quality validation, supporting informed decision making by SIU leadership.

Job description rankings/percentages are intended to reflect normal averages over an extended period of time, and are subject to daily variances. Quality and efficiency standards should at no time be compromised to meet the average expectations expressed above. Job descriptions are subject to change to accommodate organization or department needs.

ORGANIZATIONAL EXPECTATIONS:

Values

All colleagues are expected to live our values:

Excellence: We strive for the best results and always look for ways to improve.

Compassion: We care and show empathy and respect for each person.

Partnership: We are strongest when we work together and with those we serve.

Integrity: We are open and honest, and we keep our commitments.

Additional Expectations:

Manage an investigative caseload, including timely documentation and reporting of case activities.
Research and apply internal and external policies, procedures, laws, and/or regulations.
Identify and analyze suspicious billing patterns, trends, and anomalies.
Interview professionals, witnesses, and patients/members.
Perform investigative provider site visits.
Collaborate with internal partners including Legal, Compliance, Contracting, Credentialing, Government Programs, and the Health Plan Medical Directors
Serve as an internal resource and subject matter expert on FWA.
Demonstrate high standards of integrity and professionalism.

ABOUT US

At HealthPartners we believe in the power of good – good deeds and good people working together. As part of our team, you’ll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.

We’re a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.

At HealthPartners, everyone is welcome, included and valued. We’re working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.

Benefits Designed to Support Your Total Health
As a HealthPartners colleague, we’re committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal is to help you thrive physically, mentally, emotionally, and financially, so you can continue delivering exceptional care.

Join us in our mission to improve the health and well-being of our patients, members, and communities.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class.

JOB INFO

Job Identification

121460

Organization

HealthPartners/GHI, HealthPartners Enterprise

Posting Date

07/13/2026, 04:57 PM

Locations

8170 33rd Ave S - Bloomington

Work Schedule

Monday through Friday; core business hours
This is a hybrid role with onsite presence required Tuesday through Thursday. Schedule and onsite days may be subject to change based on business and team needs.

Hours Per Week/FTE

40 hrs weekly / 1.0 FTE

Job Shift

Day

Position Type

Full-time regular

Job Category

Administrative

Department

Payment Integrity

Pay Range

$29.57 - $44.35 hourly

Pay Range Statement

Compensation is based on the level and requirements of the role. Pay within our ranges may also be determined by education, experience, knowledge, skills, location, and abilities as well as internal equity. Hired candidates may be eligible to receive additional compensation based on role (e.g., shift differential, bonus, sales incentive, productivity pay, etc.).

Overtime Eligibility Status

Exempt

Worker Type

Employee

Apply Now

Refine Your Search

investigator jobs in edina, mn

Medical Review Associate Investigator

Medical Review Investigator

Surveillance Agent

Security Investigator

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Surveillance Investigator

Investigator, Special Investigations Unit (Aetna SIU)

Human Rights Investigator I

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Clinical Research Coordinator I

Senior Medical Science Liaison, Upper Midwest

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Medical Science Liaison Immunology - Admilparant (MT, MN, SD, ND, NE, WY)

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I want to receive the latest job alert for investigator in edina, mn

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