About this Fraud Prevention and Enterprise Integrity Officer role at State of Nebraska
The work we do matters!
Hiring Agency:
Health & Human Services - Agency 25
Location:
Hiring Rate:
Job Posting:
Applications No Longer Accepted On (If no date is displayed, job is posted as open until closed):
Job Description:
The position provides executive oversight of investigations, compliance, audits, analytics, payment integrity, recoveries, internal controls, and risk management across DHHS programs. Working closely with division leadership and external partners, the position develops coordinated approaches to identifying risks, strengthening accountability, and protecting public resources while ensuring appropriate access to services and fair, consistent treatment of members, providers, and stakeholders.
Salary: Anticipated salary range of $120,000 - $150,000 commensurate with education and experience, if approved.
Location: This position will be located at the Nebraska State Office Building in Lincoln, NE.
Reports to: This position will report to the DHHS Chief of Staff, Shannon Grotrian.
Examples of Work
Develop and implement an enterprise integrity strategy, governance framework, annual work plan, and performance measures aligned with DHHS priorities while proactively adapting to emerging risks and fraud schemes.
Provide strategic leadership for agency-wide fraud prevention, investigations, compliance, audits, payment integrity, recoveries, and enterprise risk management activities.
Provide strategic direction to Division Directors regarding enterprise integrity risks, emerging trends, policy development, and operational improvements.
Oversee administrative investigations, audits, provider reviews, corrective actions, payment suspensions, sanctions, and overpayment recovery activities, as appropriate.
Coordinate referrals and case information with the Attorney General, law enforcement, federal agencies, and other oversight agencies while maintaining appropriate separation between administrative and criminal functions.
Develops the use of data analytics and risk-based methodologies to identify fraud trends, payment vulnerabilities, operational risks, and systemic control weaknesses while supporting executive decision-making.
Develop and maintain policies, procedures, internal controls, quality standards, referral protocols, and documentation practices that support consistent and defensible decision-making.
Ensure compliance with applicable federal and state laws, regulations, and program requirements.
Establish, lead, and develop a multidisciplinary team while setting clear expectations for quality, collaboration, accountability, and measurable results.
Foster an enterprise culture of integrity by promoting education, information sharing, and continuous improvement across DHHS programs.
Requirements / Qualifications:
Minimum Qualifications:
- Bachelor's degree in public administration, business administration, health administration, accounting, finance, law, criminal justice, data analytics, or a related field.
- Progressively responsible leadership experience in enterprise integrity, fraud prevention, compliance, investigations, auditing, financial oversight, healthcare administration, public administration, risk management, or a related field.
- Experience leading complex initiatives involving multiple programs, divisions, or professional disciplines is required.
- Experience developing and implementing organizational strategies, policies, or operational initiatives.
Preferred Qualifications:
- Master’s degree in public administration, business administration, health administration, accounting, finance, law, criminal justice, data analytics, or a related field.
- Experience working within government, healthcare, or other publicly funded programs.
- Experience using data analytics, predictive models, and performance metrics to identify risk, improve decision-making, and strengthen operational performance.
- Professional certifications such as Certified Fraud Examiner (CFE), Certified Public Accountant (CPA), Certified Internal Auditor (CIA), Certified Information Systems Auditor (CISA), Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC), or other relevant credentials.
Knowledge/Skills/Abilities
- Knowledge of fraud prevention, investigations, compliance, auditing, enterprise risk management, internal controls, payment integrity, and public sector accountability.
- Knowledge of federal and state laws, regulations, and oversight requirements governing publicly funded programs.
- Ability to analyze complex operational, financial, and programmatic information and identify emerging risks, trends, and vulnerabilities.
- Ability to lead multidisciplinary teams that may include investigators, auditors, analysts, clinicians, financial professionals, compliance staff, or other technical experts.
- Ability to build collaborative relationships across divisions while maintaining independent oversight and sound professional judgment.
- Ability to communicate complex findings and recommendations to executive leadership, policymakers, oversight agencies, and external partners.
- Demonstrated leadership skills, including the ability to establish strategic priorities, lead organizational change, and foster a culture of integrity, accountability, and continuous improvement.
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Benefits
We offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.
Check out all that the State of Nebraska has to offer! Benefit eligibility may vary by position, agency and employment status. For more information on benefits, please visit: https://statejobs.nebraska.gov/index.html#benefits
Equal Opportunity Statement
The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.