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Working Title: Quality Assurance and Improvement Analyst

Job Class: Human Services Program Representative 2

Agency: Human Services Dept

+ **Job ID** : 91502

+ **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** : 01/16/2026

+ **Closing Date** : 01/29/2026

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

+ **Division/Unit** : DHS-Central Office / HCA MPPS Prov Elig Compl

+ **Work Shift/Work Hours** : Not Applicable Shift

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

+ **Travel Required** : No

+ **Salary Range:** $32.40 - $47.76 / hourly; $67,651 - $99,722 / 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

_This position is eligible for_ telework (https://mn.gov/mmb-stat/policies/1422-telework.pdf) _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._

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 exists to protect the integrity of Minnesota Health Care Programs by identifying errors, gaps and trends to reduce Medicaid fraud, waste and abuse. The role provides recommendations to improve policies, procedures, training and legislation, ensuring consistent and efficient provider enrollment processes. Acting as a subject matter expert, the role applies comprehensive knowledge of MHCP systems, and regulations to maintain program integrity and support ongoing modernization efforts.

This person is the SME and ensure all MHCP provider requests are appropriately screened and have eligibility determinations according to State and Federal laws and program policies

• Reviews and evaluates MHCP approved and denied enrollment requests to determine if the program is achieving its objectives by outlining report criteria and reviewing results in order to propose solutions, resolve problems discovered during the evaluation, and monitor outcomes. Documents problems and solutions, while continually analyzing and organizing data to ensure the integrity of program activity in relation to enrollment of qualified providers

• Represent the Member and Provider Services (MPS) Division at meetings with internal and external stakeholders to ensure that adequate information is effectively communicated within program guidelines

• Provide technical assistance to DHS staff and work with others on joint projects related to provider screening and enrollment activities and proper payment of claims

• Advise stakeholders (MHCP program and service policy staff, MN.IT, state and federal auditors, DHS OIG, Attorney General's Office, DHS FOD, provider associations and other provider stakeholder groups) with a comprehensive understanding of all procedural and technical aspects of program activities in relation to enrollment activities and system coding so that requested supports are within the limitations of the regulations and policies involved; assessing whether or not program parameters have been met; analyzing resource distribution to avoid duplication within or between programs; verifying that provided services are consistent with program plans. Provide on-site technical assistance, training and presentations on the Provider Enrollment processes

• Determines compliance with MHCP programs so that management is kept up to date on program activities, and program needs are identified by monitoring and identification of issues and problems, such as systems logic applicable to meet State and Federal regulations

• Conduct detailed and comprehensive research of the Minnesota Provider Screening Enrollment Portal (MPSE) and MMIS system change requests to proactively identify changes that will affect the integrity of the enrollment process so that program activities, program needs, and future program services are identified and addressed

• Provide enrollment expertise to external and internal stakeholders regarding the integrity of decisions to approve, deny, terminate, or take other action on a provider record by testifying in court cases and/or working with auditors

• Implement enrollment status changes that affect financial reporting systems for state, federal, and other funding sources. Determine when it is necessary to notify other appropriate business areas, such as policy areas or claims processing, of action taken on a provider record and ensure the necessary communication is documented

• Develop recommendations for enhancements or changes in legislation that enable Provider Enrollment to continue adding efficiencies to the processes for both DHS and providers

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, day and year for each job held.**_

3 years professional experience with Minnesota Health Care Programs (MHCP) operations or similar healthcare/ insurance related experience. Experience must include the following:

+ Experience with compliance requirements for healthcare programs

+ Experience with conducting quality and compliance review activities to ensure alignment with state and federal requirements, identifying errors, gaps and trends

+ Experience analyzing business and workflow impacts of policy and system changes

Bachelor’s Degree in Public Health, Health Care Administration, Public Administration or related field may substitute for 1 year of experience OR Master’s degree in Public Health, Health Care Administration, Public Administration or related field may substitute for 2 years of experience

Preferred Qualifications

+ Leadership skills with ability to develop the skills and capabilities of staff

+ Able to approach problems with functional analysis perspective

+ Ability to identify gaps or trends and solutions to improve processes, procedures and regulations

+ Knowledge of continuous improvement principles

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