**Working Title: Managed Care Lead Worker** **Job Class: Human Services Program Representative 2** **Agency: Human Services Dept** + **Job ID** : 83239 + **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** : 01/11/2025 + **Closing Date** : 01/24/2025 + **Hiring Agency/Seniority Unit** : Human Services Dept / MAPE DHS Central Office + **Division/Unit** : Health Care Administration / Health Care 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. This position is responsible to ensure: + MHCP recipients receive accurate and timely PMHCP (managed care) service delivery and benefits. + PMHCP recipients know the service delivery options available to them and the benefits for which they are eligible. + Accurate and appropriate managed care payments to MCOs. + State and federal laws, regulations, policy, processes, and contracts related to managed care enrollment, and education are implemented and followed. Additional responsibilities include: + Provide lead work direction to Managed Care Enrollment Coordinator team. + 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. + 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. + Oversee department, administration, and division efforts to ensure MHCP systems maintain accurate service delivery determinations. **Minimum Qualifications** Three years of professional experience in managed care enrollment utilizing systems such as MMIS. Experience must demonstrate: + Knowledge ofMinnesota Health Care Programs (example: Minnesota Care, Medical Assistance, home and community-based services) + Skilled in researching and resolving managed care enrollment related issues **Preferred Qualifications** + Knowledge of managed care policy and payment processes + Private and public sector health insurance experience + Experience with document management and storage systems such as FileNet or SharePoint. + Experience in previous leadership roles that indicate strong interpersonal and relationship building skills leading others toward a common goal. + Experience with or knowledge of continuous improvement efforts. + Excellent oral and written, formal and informal, communications tools and techniques. + Our employees are dedicated to ensuring cultural responsiveness. Preferred candidates will have a 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 careers@state.mn.us . Please indicate what assistance is needed.