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Working Title: Managed Care System Lead

Job Class: Human Services Program Representative 2

Agency: Human Services Dept

+ **Job ID** : 85852

+ **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** : 04/25/2025

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

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

+ **Division/Unit** : Health Care Administration / Eligibility and Operations

+ **Work Shift/Work Hours** : Day Shift / Varies

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

+ **Travel Required** : No

+ **Salary Range:** $31.92 - $47.05 / hourly; $66,648 - $98,240 / 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.

Minnesota Health Care Programs (MHCP) encompasses a wide array of programs such as Medical Assistance (MA) including MA for Long Term Care Services (LTC), MinnesotaCare, Minnesota Family Planning Program (MFPP), Hospital Presumptive Eligibility (HPE), Deferred Action for Childhood Arrivals (DACA), and Medicare Saving Programs, etc.

PMHCP (Prepaid Minnesota Health Care Programs) is the managed care health care service delivery for MHCP that is administered by managed care organizations on a state and county level.

Responsibilities include:

+ Represent DHS as an MMIS system expert and business lead for managed care on MN.IT projects, system enhancements, transitions to production, and project implementation for MHCP computer systems.

+ Provide oversight and technical support related to managed care systems, tools, manuals, and education in order to ensure that MHCP consumers’ health care needs are met.

+ Oversee department, administration, and division efforts to ensure MHCP systems maintain accurate service delivery determinations. Oversee department, administration, and division efforts to ensure MHCP systems maintain accurate service delivery determinations.

+ Provide oversight and technical support related to managed care systems, tools, manuals, and education to ensure that MHCP consumers’ health care needs are met.

+ Provide lead work direction to Managed Care Enrollment Coordinator team.

Minimum Qualifications

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.

Three (3) years professional Minnesota Health Care Programs (example: Minnesota Care, Medical Assistance, home and community-based services) demonstrating the following:

+ Managed Care **AND** Eligibility system experience utilizing systems such as Minnesota Eligibility Technology System (METS), MMIS & MAXIS

+ Experience assisting consumers with managed care enrollment

Preferred Qualifications

+ In-depth understanding of MHCP managed care and eligibility policy, processes, and systems to guide the implementation of new or corrected system functionality, business processes, and procedures.

+ Experience working on projects as a Subject Matter Expert (SME) or other related roles in which you are responsible to communicate policy and/or business needs. Review business and functional requirements to ensure they are correct and complete.

+ Ability to manage multiple concurrent projects and competing priorities under demanding deadlines.

+ Strong oral and written communication skills sufficient to communicate to both technical and nontechnical personnel.

+ Experience participating in user acceptance testing to validate that technical solutions work as designed according to business and functional system requirements.

+ **Decision-making experience** related to planning, organizing, directing and controlling functions to achieve organizational goals and objectives.

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

Additional Requirements

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.