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Working Title: Medicare Enrollment Coordinator

Job Class: Human Services Program Representative 1

Agency: Human Services Dept

+ **Job ID** : 85674

+ **Location** : St. Paul

+ **Telework Eligible** : Yes

+ **Full/Part Time** : Full-Time

+ **Regular/Temporary** : Unlimited

+ **Who May Apply** : Open to all qualified job seekers

+ **Date Posted** : 04/17/2025

+ **Closing Date** : 05/07/2025

+ **Hiring Agency/Seniority Unit** : Human Services Dept / MAPE DHS Central Office

+ **Division/Unit** : Health Care Administration / Purchasing and Service Delivery

+ **Work Shift/Work Hours** : Day Shift / 8:30am - 5:00pm

+ **Days of Work** : Monday - Friday

+ **Travel Required** : No

+ **Salary Range:** $28.82 - $42.31 / hourly; $60,176 - $88,343 / annually

+ **Classified Status** : Classified

+ **Bargaining Unit/Union** : 214 - MN Assoc of Professional Empl/MAPE

+ **FLSA Status** : Nonexempt

+ Designated in Connect 700 Program for Applicants with Disabilities (https://mn.gov/mmb/careers/diverse-workforce/people-with-disabilities/connect700/) : Yes

The Department of Human Services is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DHS does not participate in E-Verify.

The work you'll do is more than just a job.

At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and working to improve the well-being and quality of life for all Minnesotans. The State of Minnesota is committed to equity and inclusion, and invests in employees by providing benefits, support resources, and training and development opportunities.

This position reports to the TPA Medicare Enrollment Team within the Managed Care Contracting and Rates unit of DHS. This individual is responsible for evaluating and assigning the correct managed care product for consumers who are dually-eligible for Medical Assistance and Medicare. The individual will be familiar with eligibility requirements and policies as they relate to the Minnesota Senior Health Options (MSHO) or Special Needs BasicCare (SNBC) program(s). This position serves as a contact point for managed care organizations and county agencies with regard to enrollment questions, policies and practices. They will also be responsible for monitoring and insuring correct enrollment transactions to CMS and managed care organizations.

This position is part of a section of managed care/Medicare implementation specialists and manages Prepaid Managed Health Care Programs (PMHCP). This position develops/modifies strategies and work plans to effectively use resources and implement conversion of fee-for service resources and ensure access for members.

Main responsibilities:

+ Provide technical support and oversight to enrollment site operations and contracted health plans related to Minnesota Senior Health Options (MSHO), Special Needs Basic Care (SNBC) and Medicare Enrollment.

+ Reviews and analyzes data/information relating to MSHO, SNBC and Medicare enrollment and outcomes in order to monitor compliance, evaluate effectiveness and more effectively direct resources to address the health care needs of eligible members.

+ Process enrollments/dis-enrollments, monitor and account for and, if needed, correct transactions relating to MSHO, SNBC and Medicare enrollments and payment.Within specified time lines, ensure that adjustments are made accurately in a timely manner and in accordance with contract and/or Federal requirements.

Minimum Qualifications

Two years professional experience working with Health Care Programs and Managed Care Policy demonstrating the following:

o Working knowledge of medical program eligibility, benefits, managed care policy and payment process.

o Ability to analyze data, trends, prepares statistical reports, conduct large meetings and present information.

*Bachelor's degree or higher degree in human services, business, healthcare or related field may substitute one year of professional experience.

Preferred Qualifications

• Ability to handle difficult situations diplomatically and negotiate solutions when necessary.

• Knowledge of the state's automated eligibility system for public assistance programs (MAXIS) and the Medicaid Management Information System (MMIS).

• Knowledge of the Medicare Managed Care Enrollment and Disenrollment Regulations and the ability to interpret those regulations.

• Knowledge of the Prepaid Minnesota Health Care programs, specifically related to Minnesota Senior Health Options (MSHO) and Special Needs Basic Care (SNBC) programs and their integration with Medicare enrollment requirements.

• Understanding of the roles and relationships of county, state, federal agencies and health plans with whom the department contracts.

• Ability to interpret policy and procedure manuals.

• Experience enrolling consumers in a health plan and reviewing enrollment applications.

• Experience with the workflow component of FileNet.

• Variety of experiences working effectively with others from different backgrounds and cultures.

Additional Requirements

To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job held.

A writing sample may also be requested upon completion of an interview.

REFERENCE/BACKGROUND CHECKS - The Department of Human Services will conduct reference checks to verify job-related credentials and criminal background check prior to appointment.

AN EQUAL OPPORTUNITY EMPLOYER

Minnesota State Colleges and Universities is an Equal Opportunity employer/educator committed to the principles of diversity. We prohibit discrimination against qualified individuals based on their race, sex, color, creed, religion, age, national origin, disability, protected veteran status, marital status, status with regard to public assistance, sexual orientation, gender identity, gender expression, or membership in a local commission as defined by law. As an affirmative action employer, we actively seek and encourage applications from women, minorities, persons with disabilities, and individuals with protected veteran status.

Reasonable accommodations will be made to all qualified applicants with disabilities. If you are an individual with a disability who needs assistance or cannot access the online job application system, please contact the job information line at 651-259-3637 or email [email protected] . Please indicate what assistance is needed.