Lead Program Eligibility Auditor - Human Services Program Representative 2

State of Minnesota
  • St. Paul, MN
  • $32.97–$48.60 Per Hour
15 days ago

Job Description

Logo

When all employees are embraced, respected and heard, we will build a collaborative, equitable, inclusive and anti-racist culture where everyone thrives.

Job Details

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: 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 youll 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.

Job Summary

  • 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.*

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:

  • Conduct eligibility reviews (first or second QA).

  • Conduct medical record & claim error reviews that are a component of the Payment Error Rate Measure (PERM) Review.

  • Develop, implement, generate and revise as necessary dashboard performance reports for Program Compliance and Audits.

  • Develop, implement, generate and revise as necessary orientation program documents for Program Compliance and Audits.

  • Annually update/revise Eligibility review team's reviewer manual, incorporating federal and state regulatory changes, audit form use updates, reviewer tool use updates, etc.

Qualifications

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.

Application Details

How to Apply

Select "Apply for Job" at the top of this page. If you have questions about applying for jobs, contact the Careers Help Desk at 651-259-3637 or email careers@state.mn.us. For additional information about the application process, go to http://www.mn.gov/careers.

Contact

If you have questions about this position, contact Monica Templin at monica.templin@state.mn.us.

To receive consideration as a Connect 700 Program applicant, apply online, email the Job ID#, the Working Title and your valid Proof of Eligibility Certificate by the closing date to Alexander Duren at alexander.duren@state.mn.us.

If you are an individual with a disability and need an ADA accommodation for an interview, you may contact the Department of Human Services' ADA Coordinator at 651-431-4945 or DHS_ADA@state.mn.us for assistance.

About Human Services Dept

WE MAKE A DIFFERENCE! The Minnesota Department of Human Services impacts the lives of 1.7 million people every year, helping them meet their basic needs so they can achieve their highest potential.

Working together to improve the state we love.

What do Minnesotas State employees have in common?

  • A sense of purpose in their work
  • Connection with their coworkers and communities
  • Opportunities for personal and professional growth

Benefits

As an employee, youll have access to one of the most affordable health insurance plans in Minnesota, along with other benefits to help you and your family be well.

Your benefits may include:

  • Paid vacation and sick leave

  • 12 paid holidays each year

  • Low-cost medical, dental, vision, and prescription drug plans

  • Fertility care, including IVF

  • Diabetes care

  • Dental and orthodontic care for adults and children

  • 6 weeks paid leave for parents of newborn or newly adopted children

  • Pension plan that provides income when you retire (after working at least three years)

  • Employer paid life insurance to provide support for your family in the event of death

  • Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury

  • Tax-free expense accounts for health, dental, and dependent care

  • Resources that provide support and promote physical, emotional, social, and financial well-being

Support to help you reach your career goals:

  • Training, classes, and professional development
  • Tuition reimbursement
  • Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at studentaid.gov)

Employee Assistance Program (EAP) for work/life support:

  • A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance
  • Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
  • Daily Living/Convenience Services: Chore services, home repair, trip planning, child/elder care

Programs, resources and benefits eligibility varies based on type of employment, agency, funding availability, union/collective bargaining agreement, location, and length of service with the State of Minnesota.

EQUAL OPPORTUNITY EMPLOYERS

Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. State agencies are committed to creating a workforce that reflects the diversity of the state and strongly encourages persons of color and Indigenous communities, members of the LGBTQIA2S+ community, individuals with disabilities, women, and veterans to apply. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve Minnesotans.

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, sex (including pregnancy, childbirth, and disabilities related to pregnancy or childbirth), gender identity, gender expression, marital status, familial status, age, sexual orientation, status regarding public assistance, disability, veteran status or activity in a local Human Rights Commission or any other characteristic protected by law.

APPLICANTS WITH DISABILITIES

Minnesota state agencies make reasonable accommodations to their employees and applicants with disabilities. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at 651-259-3637 or email careers@state.mn.us and let us know the support you need.

Numbers & Facts

LocationSt. Paul, MN
Salary$32.97–$48.60 Per Hour

Skills

  • Aged Careunmatched
  • Auditingunmatched
  • Childcareunmatched
  • Data Managementunmatched
  • Department of Health and Human Servicesunmatched
  • Diversityunmatched
  • Employee Benefitsunmatched
  • Federal Laws and Regulationsunmatched
  • Health Insuranceunmatched
  • Healthcareunmatched
  • Homeland Securityunmatched
  • Legalunmatched
  • Life Insuranceunmatched
  • Maintain Complianceunmatched
  • Medical Recordsunmatched
  • Microsoft Officeunmatched
  • Orthodonticsunmatched
  • Performance Analysisunmatched
  • Policy Developmentunmatched
  • Prescription Drugsunmatched
  • Prismunmatched
  • Psychiatry and Mental Healthunmatched
  • Public Healthunmatched
  • Public Policyunmatched
  • Quality Assuranceunmatched
  • Regulationsunmatched
  • Reporting Dashboardsunmatched
  • Retirement Planunmatched
  • Software Administrationunmatched
  • State Laws and Regulationsunmatched
  • Team Playerunmatched
  • Training/Teachingunmatched
  • Tuition Reimbursementunmatched
  • Willing to Travelunmatched

Be found by employers

5,500+ employers search our resume database daily. Add yours to get found by recruiters looking for candidates like you.

Level up your application

Professional resume templates

Browse dozens of recruiter approved resume templates, layouts and formats. Choose your favorite and make it your own in minutes.

Free resume templates

Free resume builder

Improve your existing resume or start from scratch and create a standout, ATS-friendly resume. Add job-specific content, download and apply.

Free resume builder