MINIMUM QUALIFICATIONS

Two years of professional experience working with Minnesota Health Care Programs (example: Minnesota Care, Medical Assistance, home and community-based services) demonstrating the following:

• Managed care and Affordable Care Act experience
• Eligibility system experience such as: Minnesota Eligibility Technology System (METS), MMIS & MAXIS
• Health Care Program enrollment experience
• Bachelor’s degree or higher in public health, social work or related field may substitute for one (1) year of professional experience

PREFERRED QUALIFICATIONS

• Private and public sector health insurance experience.
• Knowledge of Managed care policy and payment process.
• Experience enrolling consumers in a health plan and reviewing enrollment applications.
• Experience with the workflow component of FileNet.
• Experience working with SharePoint.
• Experience with or knowledge of continuous improvement efforts.
• Variety of experiences working effectively with others from different backgrounds and cultures.

ADDITIONAL REQUIREMENTS

REFERENCE/BACKGROUND CHECKS - The Department of Human Services will conduct reference checks to verify job-related credentials and criminal background check prior to appointment.

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

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.

Responsibilities include:

• Monitor, account for, and correct MHCP transactions relating to managed care enrollment and capitation payments so that payments and adjustments are accurate, timely, and meet contract requirements and the needs of consumers.
• Provide technical support, services, and education to MCOs and MHCPE related to managed care systems and enrollment.
• Review and analyze reports and data, monitor changes and other activities, and take needed actions related to managed care enrollment and education compliance.
• Participate in efforts to create, update, and distribute consumer PMHCP, MCO, and MHCPE educational materials and information.
• Participate in department, administration, and division efforts related to MHCP systems, continuous improvement efforts, and other projects related to managed care