Lead Program Eligibility Auditor - Human Services Program Representative 2

Working Title: Lead Program Eligibility Auditor

Job Class: Human Services Program Representative 2

Agency: Human Services Dept

• Job ID : 97283

• 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 : 09/25/2026

• Closing Date : 10/08/2026

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

• Division/Unit : DHS-Central Office / Program Compliance & Audits HC

• Work Shift/Work Hours : Day Shift, 8:00am - 4:30pm

• Days of Work : Monday - Friday

• Travel Required : No

• Salary Range: $32.97 - $48.60 / hourly; $68,841 - $101,476 / 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.

***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 Lead Program Eligibility Auditor supports the Program Compliance and Audits Manager and Supervisor, acting as their liaison when they cannot be present. The incumbent will report information to management that is relevant to maintaining an efficient and productive work environment. This role also exists to provide a first line resource person for the program eligibility auditors on their team, functioning as a decision maker when two auditors do not agree on an audit finding, an educator when an auditor is unclear on an audit process, relevant policy/regulation or audit procedure, an issue/question escalator when necessary and a subject matter expert (SME) on the audit their team is conducting.

Responsibilities include but may not be limited to:

• Conducteligibilityreviews(firstorsecondQA).

• Conductmedicalrecord&claimerrorreviewsthatareacomponentofthePaymentErrorRateMeasure(PERM)Review.

• Develop,implement,generateandreviseasnecessarydashboardperformancereportsforProgramComplianceandAudits.

• Develop,implement,generateandreviseasnecessaryorientationprogramdocumentsforProgramComplianceandAudits.

• Annuallyupdate/reviseEligibilityreviewteam’sreviewermanual,incorporatingfederalandstateregulatorychanges,audit form use updates, reviewer tool use updates, etc.

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._

Three (3) years of experience in program eligibility and/or auditing.

Experience must also demonstrate:

• Monitoring and administrating program requirements for eligibility.

• Investigating, auditing, reviewing, and analyzing diversified procedures and standards.

• Experience working with MAXIS, METS, MMIS and PRISM or other related data management tools and procedures such as input, collection and retrieval systems.

• Experience with Microsoft Office applications.

*A Bachelor’s degree in Public Health, Health and Human Services, public policy, or another related degree field may substitute for one (1) year of professional experience.

OR

**A Master’s degree in Public Health, Health and Human Services, public policy, or another related degree field may substitute for two (2) years of experience.

Preferred Qualifications

• Experience in Healthcare program eligibility or auditing.

• Experience as a lead worker in program eligibility, auditing, or a related field.

• Working knowledge of Minnesota’s Health Care and other eligibility programs, regulations, policies and determinations.

• Variety of experiences working effectively with others from different backgrounds and cultures.

Additional Requirements

REFERENCE/BACKGROUND CHECKS – DHS will conduct reference checks to verify job-related credentials and a 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.