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Working Title: Appeals Representative

Job Class: Human Services Program Representative 1

Agency: Human Services Dept

+ **Job ID** : 90095

+ **Location** : St. Paul

+ **Telework Eligible** : Yes

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

+ **Regular/Temporary** : Limited

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

+ **Date Posted** : 11/06/2025

+ **Closing Date** : 11/17/2025

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

+ **Division/Unit** : Health Care Administration / Integrity and Accountability - Eligibility Appeals

+ **Work Shift/Work Hours** : Day Shift / 8:00am - 4:30pm

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

+ **Travel Required** : No

+ **Salary Range:** $29.25 - $42.94 / hourly; $61,074 - $89,658 / annually

+ **Classified Status** : Unclassified

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

+ **End Date** : This position is expected to last up to 1 year

+ **FLSA Status** : Nonexempt

+ Designated in Connect 700 Program for Applicants with Disabilities (https://mn.gov/mmb/careers/diverse-workforce/people-with-disabilities/connect700/) : No

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 temporary and includes full state fringe benefits; the position is expected to last up to one (1) year.

This position is eligible for telework for applicants who reside in Minnesota or in a bordering state, with supervisory approval and satisfactory performance. If you live in a state bordering Minnesota, you must live within 50 miles or less from the primary work location to be eligible for telework.

This position exists to represent the Department of Human Services in recipient eligibility appeals for certain Minnesota Health Care Programs (MHCP) administered through the Minnesota Eligibility Technology System (METS).

As a respondent for MHCP recipient eligibility appeals, the incumbent functions as an expert-level case worker tasked with researching and analyzing each appeal case to discern whether agency actions followed established program guidelines. This position makes case updates and corrections as needed to arrive at appropriate program eligibility for recipients and defends the agency’s legal position on appeal where necessary. The incumbent will use their knowledge of MHCPs, METS, and other supporting resources to perform daily tasks.

Responsibilities include:

+ Research and respond to decisions and determinations that have been formally appealed or referred to an administrative hearing officer. Consequently, correct case errors and contact the appellant to discuss resolution when applicable, draft persuasive policy positions explaining the agency’s determination and applying law and agency policy to individual cases. Follow up on the implementation of the resolution or decision and draft and/or respond to requests for reconsideration and/or appeals.

+ Determine eligibility for certain Minnesota health care programs.

+ Collaborate with staff from DHS, MNsure, and other state agencies and divisions to research, analyze and respond to agency eligibility appeals.

+ Maintain expert knowledge of changes and updates to policies, procedures, practices, forms, available resources, and systems used in relationship to his/her job functions.

Minimum Qualifications

Two years professional experience administering eligibility for Medical Assistance or MinnesotaCare using automated eligibility systems and demonstrating the following:

+ Experience with eligibility systems such as the Minnesota Eligibility Technology System (METS) and Minnesota Medicaid Information System (MMIS);

+ Research and analytical experience and the ability to apply those skills in problem resolution.

Preferred Qualifications

+ Advanced knowledge and currently administering multiple Minnesota Health Care Programs, including Medical Assistance and MinnesotaCare within the Minnesota Eligibility Technology System (METS)

+ Ability to explain complex policies and program constraints effectively, both orally and in writing

+ Demonstrated organizational and time management skills

+ Proficiency with Microsoft Office products (Word, Excel, Outlook) and the ability to navigate multiple software applications

+ Knowledge of state and federal regulations governing Minnesota Health Care Programs, including: processes, procedures, appeals, regulations, and determining eligibility for MinnesotaCare and/or Medical Assistance

+ Demonstrated ability to multi-task and quickly switch focus

+ 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.