BPI Investigator V Region 06

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.

Functional Title: BPI Investigator V Region 06 
Job Title: Investigator V 
Agency: Health & Human Services Comm 
Department: Benefits Program Integrity 
Posting Number: 7372 
Closing Date: 08/05/2025 
Posting Audience: Internal and External 
Occupational Category: Legal 
Salary Group: TEXAS-B-20 
Salary Range: $4,263.16 - $6,779.25 
Pay Frequency: Monthly
Shift: Day 
Additional Shift: Days (First) 
Telework:  
Travel: Up to 70% 
Regular/Temporary: Regular 
Full Time/Part Time: Full time 
FLSA Exempt/Non-Exempt: Nonexempt 
Facility Location:  
Job Location City: HOUSTON 
Job Location Address: 6161 SAVOY DR STE 600 
Other Locations:  
MOS Codes: 5805,5813,5819,5821,5822,7596,8012,14N,14NX,183X,1N0X1,1S0X1,250X,311A,31A,31B,31D,31PX,351L,351M 
35A,35L,35M,3D0X3,3E7X1,3P0X1,43HX,4B0X1,4E0X1,5I0,649X,655X,683X,71SX,749X,783X,89D,89E,EOD,INV,IS 
IV,LN,MA,ME,MLES,MSSD,MSSE,MSSR,MST,OAP12,OAP14 
 

The Office of Inspector General (OIG) Benefits Program Integrity (BPI) Field Investigator V reports to the BPI unit manager/director . BPI Field Investigators conduct highly complex administrative and criminal investigations involving recipients of HHS programmatic services, such as Medicaid; the Children’s Health Insurance Program (CHIP); the Supplemental Nutrition Assistance Program (SNAP); Temporary Assistance for Needy Families (TANF); and the Women, Infants, and Children’s (WIC) program. The BPI Field Investigator V is responsible for investigating referrals of fraud, waste, and abuse by HHS clients, conducting thorough research and evidence gathering activities, and determining whether the information collected represents a violation of program laws, rules, or regulations according to applicable evidentiary standards.

The Field Investigator V coordinates and conducts investigations according to laws, regulations, agency policies, and professional standards. The position reviews and analyzes records and reports from multiple agency, state, and federal databases; collaborates with both internal and external stakeholders to obtain verification and evidence; understands and applies relevant eligibility requirements; and calculates and establishes overpayment claims. The position obtains business records affidavits, submits subpoenas, and coordinates with law enforcement or other state and federal entities. Field Investigators are responsible for conducting investigative activities to collect evidence that satisfies either the “clear and convincing” standard for administrative fraud proceedings or the “beyond a reasonable doubt” standard for criminal fraud proceedings. This may include obtaining subject and witness statements, conducting interrogative interviews, identifying and locating involved parties, and possibly conducting surveillance. Field Investigators present evidence and testify at both HHS administrative hearings and criminal proceedings.

The position prepares and presents training; reviews and/or develops investigative techniques; assists with development of policies and procedures for conducting investigations; recommends improvements, changes, or modifications to BPI processes to increase efficiency and effectiveness of division activities and promote program integrity; and performs other related duties as assigned. May assist the Electronic Benefits Trafficking (EBT) division in conducting covert benefits trafficking investigations. Works under limited supervision with considerable latitude for the use of initiative and independent judgment.

***As of the date of this job posting, BPI investigators currently serve on a mobile work status, with the understanding that the classification of mobile work is subject to revert back to a traditional on-site work or telework environment based upon agency needs and/or upon employee performance at any time. ***

Essential Job Functions: 

35% Researches, collects evidence, reviews records, and examines potential criminally prosecutable allegations through multiple agency, state, and federal systems to determine program compliance and identify fraud. Interacts and exchanges information with various internal and external stakeholders; coordinates with law enforcement organizations and other state and federal agencies; conducts subject, witness, and collateral interviews regarding suspected violators to meet stringent evidentiary standards; completes other evidence-gathering techniques as necessary to substantiate fraud; and coordinates complex investigations.

30% Coordinates, evaluates, summarizes, and documents investigative findings. Prepares records, correspondence, and complex investigative reports. Examines, investigates, and analyzes the client’s activities to ensure compliance with statutory standards and regulations. Reviews and researches the legal aspects of investigations and recommends action as appropriate. Provides information for subpoena drafting and serving. Prepares cases for presentation at hearing or in court. Testifies and presents evidence in formal hearings and court proceedings.

20% Calculates overpayments across multiple programs with differing and intricate requirements that vary depending upon the services and circumstances of a particular case. Establishes intentional program violation overpayment claims. Tracks adjudication and disposition actions, initiates restitution collection, and coordinates disqualifications, as applicable.

10% Maintains clear and thorough investigative documentation and implements well-organized electronic filing and documentation systems. Employs organizational techniques to manage a high volume of investigations at various stages simultaneously, including planning travel and coordinating field activities. Responds to inquiries, callbacks, and correspondence from principles and collaterals involved in an investigation, providing accurate and clear information and employing investigative interviewing techniques to obtain information relevant to the investigation.

5% Coordinates with BPI leadership to recommend and implement process improvements that increase efficiency and effectiveness of investigative activities and documentation. Adheres to confidentiality requirements and records retention schedules. May review samples of completed investigations to ensure the use of consistent and correct application of policy and promote quality. May monitor and report on investigative trends and statistics. May prepare and deliver training, assist with policy and procedure or job aid development and review, and provide input into and assist in testing automated system enhancements or fixes.

Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.

Registrations, Licensure Requirements or Certifications:  

Current, Valid Driver’s License Required  
 
Knowledge Skills Abilities:  

• Knowledge of office management and HHS administrative procedures.
• Knowledge of investigative principles, techniques, and procedures.
• Knowledge of administrative hearing and court procedures, practices, and rules of evidence.
• Knowledge of state and federal laws, regulations, and policies related to health and human services.
• Knowledge of HHS social services programs and eligibility requirements.
• Experience in applying HHS social services program eligibility requirements to recipient investigations.
• Experience in using automated systems for documentation, research, and tracking.
• Skill in communicating effectively both orally and in writing.
• Skill in conducting investigative interviews and interrogations, both remotely and in person.
• Skill in conducting legal research and analysis.
• Skill in the use of computer/laptop equipment and applicable software applications.
• Skill in performing sophisticated budget calculations and using mathematical formulas.
• Skill in handling multiple competing priorities and meeting deadlines.
• Skill in using Excel and other Office Suite software applications to analyze data and produce complex reports.
• Ability to establish and maintain effective working relationships with others.
• Ability to organize research and gather evidence.
• Ability to interpret and apply laws and regulations.
• Ability to plan, organize, and conduct multiple complex investigations simultaneously.
• Ability to apply agency policies and guidelines and determine employee or recipient compliance.
• Ability to compile, evaluate findings, and present information relevant to investigations.
• Ability to use facts to prepare high-quality investigative reports for administrative hearings and criminal prosecution with strong attention to detail that clearly demonstrate how the evidence gathered proves that fraud occurred.
• Ability to provide factual and convincing testimony in hearings or court proceedings.
• Ability to develop training materials and instruct and train others.

Initial Screening Criteria: 

Graduation from an accredited high school or GED. Graduation from an accredited four-year college or university with major coursework in business, public administration, criminal justice, or a field related to the assignment OR four years’ experience conducting administrative or criminal investigations. College education and qualifying work experience may be substituted for one another on a year for year basis up to four years to meet the initial screening criteria. 

Additional Information:  

This position requires 70% travel.

The OIG is responsible for preventing, detecting, auditing, inspecting, reviewing and investigating fraud, waste and abuse in the provision of HHS in Medicaid and other HHS programs. Potential employees of OIG are subject to criminal background checks in accordance with the HHS Human Resources policy. Selected applicants must complete a national fingerprint-based criminal background check through the Texas Department of Public Safety (TDPS) and Federal Bureau of Investigations (FBI) to determine if they have criminal history record information that constitutes a bar to employment.

OIG will request that all applicants considered for an interview provide responses to essay questions. Failure to respond to the request could disqualify an applicant from the interview process.

The posted salary range reflects the minimum and maximum allowable by state law. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual Chapter 7.

In compliance with the Americans with Disabilities Act (ADA), HHS 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 AccessHR 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.

HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.

Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.

Active Duty, Military, Reservists, Guardsmen, and Veterans:

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’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS 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 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.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework.  Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.