Medicaid Compliance and Investigations Manager / Human Services Manager 2

Medicaid Compliance And Investigations Manager

Job Class : Human Services Manager 2

Agency : Human Services Dept

Location : St. Paul

Telework Eligible : Yes

Full / Part Time : Full-Time

Regular / Temporary : Unlimited

Who May Apply : Open to all qualified job seekers

Closing Date : 10 / 22 / 2025

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

Division / Unit : Department of Human Services (DHS) / Office of Inspector General (OIG) - Program Integrity Oversight (PIO) Operations Management

Work Shift / Work Hours : Day Shift / 8 : 00 a.m. - 4 : 30 p.m.

Days of Work : Monday - Friday

Travel Required : Yes

Salary Range : $43.38 - $62.41 / hourly; $90,577 - $130,312 / annually

Classified Status : Classified

Bargaining Unit / Union : 220 - Manager / Unrep

FLSA Status : Exempt - Executive

Designated in Connect 700 Program for Applicants with Disabilities : Yes

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, 10% travel.

The Medicaid Compliance and Investigations Manager is responsible for providing oversight of Medicaid program integrity functions, including screening, audits, intake and investigations. This position ensures compliance with federal and state requirements, strengthens fraud prevention and detection efforts, and promotes accountability through cross-agency collaboration and data-driven oversight.

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 and year for each job held.

Demonstrated leadership experience

Leadership experience can include :

Experience as a supervisor, lead worker, 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 :

AND

Five (5) years of experience providing strategic direction to a work unit responsible for investigatory, compliance, or program integrity activities in Minnesota Health Care Programs or a comparable setting.

AND

Experience must include :

Working knowledge of program integrity efforts to prevent, detect, or address fraud, waste, or abuse.

Leading, supervising, or coordinating teams.

Using data, research, or analytics to guide decisions and measure results.

Building effective working relationships with partners such as community organizations, contractors, government agencies, or law enforcement.

Preferred Qualifications

A thorough working knowledge of :

Minnesota Health Care Programs

Medical Assistance, Minnesota's Medicaid program.

Medicaid provider audits and investigations methods and procedures.

Medicaid provider screening and investigatory intake methods and procedures.

Recipient fraud investigations.

Experience collaborating with Licensing Division or similar unit to develop, implement, and refine program standards that strengthen service delivery and safeguard the integrity of HCBS programs.

Awareness of Department of Human Services programs and services.

Demonstrated ability to provide effective leadership that inspires a team effort toward accomplishing division goals and objectives.

Demonstrated ability to effectively communicate verbally and in writing.

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

Additional Requirements

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 careers@state.mn.us. Please indicate what assistance is needed.