SMRT Appeals and Team Lead - Human Services Program Representative 2 at State of Minnesota
Saint Paul, Minnesota, USA -
Full Time


Start Date

Immediate

Expiry Date

30 Aug, 25

Salary

47.05

Posted On

25 Jul, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Mentoring, Writing, Poms, Mets, Time Management, Cfr, Medical Records, Assessment Tools, Excel, Sharepoint, Medical Terminology, Mmis, Outlook, Documentation, Accessibility, Coaching, It, Customer Service Skills, Human Services

Industry

Hospital/Health Care

Description

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 State Medical Review Team (SMRT) Appeals and Team Lead provides advanced technical leadership and expertise in disability determination across Minnesota Health Care Programs, including Medical Assistance ABD, MA-EPD, TEFRA, Managed Care Exclusion, SNBC, and MA Home and Community-Based Waivered services. This position serves as the primary point of contact for SMRT’s appeals process, representing the department in Fair Hearings and ensuring that determinations are accurate, policy-compliant, and defensible under federal and state guidelines.
In addition to leading and coordinating SMRT’s appeals work, the Appeals and Team Lead supports staff by providing day-to-day technical guidance, mentoring, workflow monitoring, quality assurance, and assistance with specialized case consultations. This position identifies and implements process improvements, contributes to the ongoing refinement of policies and procedures, and collaborates with leadership to enhance efficiency and outcomes. The Appeals and Team Lead plays a key role on the SMRT Leadership Team, guiding daily operations and supporting initiatives to improve client, provider, and staff experiences while maintaining compliance with state and federal requirements.

MINIMUM QUALIFICATIONS

Three (3) years of specialized experience interpreting and applying Social Security Disability laws sufficient to issue accurate and timely disability determinations in accordance with state and federal laws and agency policies and procedures.

Experience must demonstrate all of the following:

  • Advanced knowledge of disability evaluation frameworks such as SSA medical listings, vocational rules, CFR, POMS, and SSRs.
  • Understanding of medical terminology as it relates to physical and mental health conditions documented in medical records.
  • Experience writing detailed briefs, case summaries, or documentation for disability or legal proceedings that demonstrate the ability to clearly and accurately present medical, vocational, or legal analysis aligned with program requirements.

PREFERRED QUALIFICATIONS

  • Eligible for Direct Payment Non-Attorneys (EDPNA) status or licensed Social Security Disability Law Attorney highly preferred.
  • Experience representing cases in Fair Hearings or similar administrative proceedings.
  • Proficiency in the following systems: ISDS, MAXIS, MMIS, METS, SSIS, MnCHOICES Assessment Tools, and SMI.
  • Proven ability to provide coaching, mentoring, and technical guidance in a high-volume environment.
  • Strong time management, analytical, problem-solving, and prioritization skills, with ability to work well under pressure.
  • Strong customer service skills, including the ability to communicate professionally and clearly over the phone, in person, and in writing.
  • Proven ability to build and maintain effective working relationships with internal teams and external stakeholders (counties, providers, clients, advocates, etc.)
  • Demonstrated organizational skills and the ability to manage multiple projects with competing deadlines
  • Proficiency with Microsoft Office Suite (Outlook, Word, Excel), SharePoint and Adobe Pro
  • Ability to work independently and collaboratively as part of a team
  • Understanding of DHS policies, procedures, processes, laws, and rules and related Minnesota State statutes that govern the work of the State Medical Review Team.
  • Advanced knowledge of state standards for communication, accessibility, and equity
  • Variety of experiences working effectively with others from different backgrounds and 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.
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

Responsibilities

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.

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