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

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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: 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: Yes

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 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 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:

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

• 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

• 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

Qualifications

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.

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 the position, contact Lori Shimon at lori.shimon@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 JaKeya Spencer at JaKeya.Spencer@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.