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Working Title: Director, Health Improvement and Benefit Design

Job Class: Human Services Manager 4

Agency: Human Services Dept

+ **Job ID** : 86072

+ **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** : 05/06/2025

+ **Closing Date** : 05/27/2025

+ **Hiring Agency/Seniority Unit** : Human Services Dept / DHS Manager

+ **Division/Unit** : Health Care Administration / Research and Quality

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

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

+ **Travel Required** : No

+ **Salary Range:** $50.25 - $71.95 / hourly; $104,922 - $150,231 / annually

+ **Classified Status** : Classified

+ **Bargaining Unit/Union** : 220 - Manager/Unrep

+ **FLSA Status** : Exempt - Executive

+ 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 is eligible for telework to applicants who reside in Minnesota or a bordering state. Effective June 1, employees living within 50 miles of the office location listed above will be required to work in the office at least 50% of the time each month. For those who live 50 or more miles away, with supervisory approval and satisfactory performance are eligible to telework up to 100% of the time._

This position exists to manage the Health Improvement and Benefit Design (HIBD) division which includes Fee-for-Service Outpatient Rates team, Cost Based Rates team, Benefit Policy team, and the Population Health Innovation (PHI) team. As part of the DHS Health Care Administration (HCA) leadership, the incumbent oversees the design, implementation, and maintenance of the fee-for-service Medical Assistance and MinnesotaCare benefit sets. This position is also responsible for coordinating the coverage policies with other areas within DHS, including Medicaid Payments and Provider Services, Healthcare Eligibility and Access, Integrated Health Partnerships, Managed Care, and other Medicaid divisions throughout the agency including but not limited to behavioral health, disability services etc. This position manages four sections, the Outpatient Rates Unit, Cost Based Rates Unit, the Benefit Policy Unit, the Population Health Innovation Unit as well as an administrative assistant who supports the entire fee-for-service program within HCA.

This position also possesses deep, substantive knowledge in policies and procedures with statewide significance and that impact multiple policy areas of the department, identifying impacts of current and proposed policy and law changes and recommending and negotiating alternatives that maintain program quality and comply with applicable state and federal laws. Duties include defining policy alternatives, negotiating proposed changes and priorities with other directors/managers, setting strategic direction for maximum functionality, and managing complex relationships with various external and internal stakeholders. This position is also responsible for relationships with school districts, overseeing the federally required Early, Periodic Screening, Diagnosis and Treatment (EPSDT) program for children enrolled in Medicaid, overseeing numerous rate methodologies with agency wide impacts and maintaining collaboration with tribes to ensure consultation occurs when changes could impact tribes and tribal health systems.

As a member of the HCA leadership, this position works with other Medicaid program directors and their delegates and directs a team of managers to establish goals consistent with agency priorities, manage resources, and strategically plan for coordinated efforts. The primary responsibilities of this position are to:

+ Lead the development of fee-for-service program benefit and rate initiatives across the agency;

+ Oversee the design and delivery of healthcare services within the fee-for-service program;

+ Coordinate the integration of benefit policy, or rates, requirements in the MCO contracts;

+ Lead implementation efforts, ensuring best use of business and technology resources;

+ Manage internal and external stakeholder relationships pertaining to any and all fee-for-service healthcare purchasing strategies;

+ Maintain a deep knowledge of the policies and procedures within the division teams so as to identify impacts of current and proposed policy and law changes;

+ Negotiate proposed changes and work priorities with other business areas;

+ Manage four units including 4 managers (Human Services Manager 2) and an OAS Senior directly.

+ Set strategic direction for future of the FFS Medicaid program to account for ever changing health care landscape and improve service delivery for members.

Minimum Qualifications

3 years of leadership experience managing health care programs, including strategic planning and directing the work of staff.

Experience demonstrates:

+ Extensive knowledge of the health care delivery system and marketplace.

+ Experience working with and an understanding of health care benefits policy and rates, including the relationship between services, disparities in health outcomes, and issues related to access.

+ Knows fee-for-service vs. managed care concepts with ability to optimize funding through the effective management of both payment options.

+ Experience with and understands complex government processes, federal-state connections, system/infrastructure design concepts, and fiscal responsibility and accountability methods.

Preferred Qualifications

+ Background and experience managing or leading within a health care organization or managing or leading large areas of health care policy that impact benefit, rate, and service delivery design of health care services.

+ Knowledgeable in best practices and state/federal expectations associated with health care purchasing strategies, budget management, data integrity, performance measurement, contractual agreements, and livery concepts and options; payment system and service delivery models; contractual agreement mechanisms and logistics; and strategic planning.

+ Strong analytical, problem solving, and organizational skills with the ability to produce and measure performance and results.

+ Both broad and extensive health care expertise and experience as a health care purchasing policy specialist.

+ Understanding of the complexity of Minnesota’s federal and state relationship and funding sources.

+ Ability to recognize the need for and strategically utilize experts in the areas of: managed care, purchasing, developing service delivery systems, payment systems, rate-setting, financing, client service systems, quality assurance/integrity, legal services, and accountability.

+ Ability to identify, assess, and mitigate different types of risks.

+ Extensive political savvy with a human relations and negotiations skills package needed to interact with and understand a highly diverse clientele including executive level management, legislators, the provider industries, and highly visible interest groups.

+ Experience and skills needed to research, develop, and recommend resource acquisition, utilization, and management strategies.

+ Knowledge of and ability to interpret state and federal level policies impacting HCA’s programs, policies, health care purchasing strategies, and operations.

+ Able to effectively engage management and staff in needed implementation discussions and facilitate planning.

+ Strong oral and written communication skills, with the ability to bring groups to consensus, broker agreements, and clearly state and defend a position.

+ Skilled presenter and negotiator with foresight and ability to determine the impact of decisions.He/she has the skills to manage large-scale contract operations, manage relations with health plans, and ensure that negotiated contracts will produce intended results at a cost acceptable to the state.

+ Experience in legislative policy-making.

+ 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.

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.