Medicaid Provider Eligibility, Compliance and Risk Assessment Manager / Human Services Manager 2

Working Title: Medicaid Provider Eligibility, Compliance and Risk Assessment Manager

Job Class: Human Services Manager 2

Agency: Human Services Dept

• Job ID : 97056

• 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 : 09/16/2026

• Closing Date : 10/06/2026

• Hiring Agency/Seniority Unit : Human Services Dept / DHS Manager

• Division/Unit : DHS-Central Office / HCA MPPS Director

• Work Shift/Work Hours : Day Shift

• Days of Work : Monday - Friday

• Travel Required : Yes, up to 5%

• Salary Range: $44.80 - $64.46 / hourly; $93,542 - $134,592 / 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

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 oversee the management, compliance, and continuous improvement of MPPS provider eligibility and compliance functions, including provider screening, enrollment, revalidation, provider oversight, and the implementation of a new, structured provider enrollment risk assessment and readiness framework. These functions serve as Minnesota Medicaid’s front door for providers seeking to deliver Minnesota Health Care Programs (MHCP) services or receive public funds. The position is responsible for ensuring that provider eligibility and enrollment decisions are accurate, consistent, legally supportable, risk-based, and aligned with federal and state requirements. Principal responsibilities of this position include:

1. Ensuring provider eligibility, screening, enrollment, revalidation, and compliance operations are conducted in accordance with state, federal, and program integrity requirements;

2. Overseeing the organizational infrastructure, performance, and decision-making framework for provider eligibility and compliance functions, including the implementation and ongoing management of provider enrollment risk and readiness assessments; and

3. Connecting provider eligibility, compliance, risk assessment, technology, data, and program integrity outcomes to broader MHCP, DHS, Medicaid, licensing, and health care industry priorities

All DHS Leaders are expected to demonstrate and develop the six (6) competency themes from the Enterprise-wide Leader Competency Model:

• Leading Self

• Leading Others

• Leading the Organization

• Leading Outside the Organization

• Leading with DEAI

• Getting Work Done

Minimum Qualifications

Demonstrated leadership experience*

*Leadership experience can include:

• Experience as a supervisor, leadworker, team lead, project lead;

• Completion of a State of Minnesota leadership program (e.g. ELI, L4);

• A paid/unpaid position leading a program or chairing a committee (e.g. ERG) - experience must include:

• 1+ year of experience identifying issues, goals and strategic actions

• 100+ hours per year time commitment

AND

5 years of professional work experience in health care provider screening, licensing, enrollment, revalidation, compliance or regulatory requirements. Experience must include the following:

• Experience with federal and state laws and other factors impacting MHCP provider eligibility, enrollment, compliance, screening, risk assessment, and participation decisions

• Experience with provider enrollment and screening systems, business rules, data elements, interfaces, and information sources used to verify provider and ownership information and support risk-based decision-making

• Knowledge of provider eligibility, enrollment, compliance, screening, licensing, and risk assessment infrastructures and associated data systems and interfaces

Preferred Qualifications

• Managerial skills needed to hire, effectively utilize, position, develop, and hold accountable qualified staff

• Knowledge of the legislative process, legal due process, and the State’s contracting process. Ability to draft, critique, and assess the implications of legislative, regulatory, and contract language

• Sufficient technical capabilities to use and leverage technology, data analytics, system integrations, and automated information sources to improve provider oversight and risk assessment

• 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.

This position requires successful completion of the following:

It is the policy of the Department of Human Services that the individual selected for this position successfully complete a background investigation prior to employment, including the following components:

Criminal background check

Reference check

Fingerprinting check (MNJIS/CJIS)

Complete the Criminal Justice Information System (CJIS) Security Awareness training within 3 business days from the start of employment; and successfully obtain/retain CJIS certification annually.

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.