Medicaid Provider Audits & Investigations Supervisor​/Human Services Supervisor

Overview

The Department of Human Services (DHS) 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 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. Approximately 25% travel.

The supervisor directs Medicaid Provider Audits & Investigations (MPAI) investigators in the performance of their duties. Responsibilities include but are not limited to:

• Direct the identification and investigation of fraud, waste, abuse and error by health care providers and recipients participating in Minnesota’s Health Care Program (MHCP).
• Enforce compliance with state and federal laws and regulations governing the programs.

Leadership experience can include:

• Experience as a supervisor, lead worker, team lead, project lead, or mentor;
• 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) with experience including:
• 1+ year of experience identifying issues, goals and strategic actions
• 100+ hours per year time commitment

Four (4) years of experience conducting claims, health care or human services investigations or audits, quality monitoring of funded programs; or oversight of programs related to Minnesota Health Care Programs or health care fraud. AND Experience must demonstrate the following:

• Ensuring compliance with state and federal laws regarding health care programs.
• Recommend, develop, approve and/or implement policies to define an administrative system to be utilized by staff.
• Direct the development, implementation and maintenance of a system for analysis of providers.
• Utilize technical skills primarily to analyze data and make recommendations.

• Knowledge of federal regulations, state statutes, and departmental rules, policies and procedures related to the public programs.
• Experience with the administrative hearing process and testifying at hearings.
• Knowledge of local human service agencies, state welfare systems and health care delivery systems.
• Skills in investigations and interviewing technique and investigatory process; skills in problem solving and decision-making techniques.
• Understanding complex interrelationships of data, information, and evidence that are obtained or observed during an investigation.
• Adapts to changing priorities, situations and demands.
• Ability to handle multiple tasks and priorities effectively and efficiently; willingness to help, support, and provide feedback to others.
• Able to effectively communicate with both technical and non-technical personnel, county users, internal DHS staff and external agencies.
• Experience working with people from different backgrounds and cultures.

This position requires successful completion of the following:

• 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.

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If you have questions about the position, contact Melanie LaBrie rie.us. If you are a Connect 700 applicant, please…