Lead Restricted Recipient Senior Investigator / Human Services Program Consultant Job in St. Paul

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St. Paul, Minnesota (MN)

Employer:	Department of Human Services - Direct Care and Treatment
Job Ref:	76409
Job Type:	Full Time
Location
City:	St. Paul
State:	Minnesota (MN)
Zip Code:	55102
Description
When all employees are embraced, respected and heard, we will build a collaborative, equitable, inclusive and anti-racist culture where everyone thrives. Working Title: Lead Restricted Recipient Senior Investigator Job Class: Human Services Program Consultant Agency: Human Services Dept Job ID: 76409 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: 05/15/2024 Closing Date: 05/21/2024 Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office Division/Unit: Department of Human Services (DHS) / Office of Inspector General (OIG) Restricted Recipient Prg Work Shift/Work Hours: Day Shift / 8:00 a.m. - 4:30 p.m. Days of Work: Monday - Friday Travel Required: Yes Salary Range: $33.90 - $50.27 / hourly; $70,783 - $104,963 / annually Classified Status: Classified Bargaining Unit/Union: 214 - MN Assoc of Professional Empl/MAPE FLSA Status: Exempt - Administrative Re-Posting: Yes Designated in Connect 700 Program for Applicants with Disabilities : Yes 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. 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. Job Summary If you previously applied to this posting from 05/02/2024 - 05/08/2024 you do not need to apply again. This position has a flexible work arrangement that may allow for Telework (within Minnesota or neighboring States) and flexible hours options are available or a mixture of working in our office and Telework . Approximately 5% travel to meetings. This position exists to direct and coordinate restricted recipient program efforts of the Minnesota Restricted Recipient Program (MRRP) and assist in managing the participants in the Universal Restrict Recipient Program (URRP). Responsibilities include but are not limited to: • Running quarterly meetings for the URRP. • Support, develop, and lead URRP efforts. • Provide guidance, direction, and management to the URRP from a Restricted recipient program oversight and Office of Inspector General (OIG) perspective. • Provide technical consultation on legislative, policy, and compliance issues. • Manage writing and presenting of appeals in the Supervisor absence and assure the Human Service Judge (HSJ) is provided all necessary information and material to successfully pursue Department of Human Services (DHS') actions. Qualifications* 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. Three (3) years of specialized professional experience directing, managing, and developing activities of Minnesota Restricted Recipient Program (MRRP). Experience must demonstrate the following: • Registered Nurse (RN) License. • Experience working with or for a Managed Care Organization. • Analyze claims data, provider documentation, financial records, and other restricted recipient program related data and identify discrepancies. •Knowledge of state requirements and procedures sufficient to draft and process contracts. Preferred Qualifications • Knowledge of the following: o Legislation, rule, and managerial approaches to human services programs, with MRRP being prioritized. o Fee-for-service and managed care programs. o Third party liability and benefit recovery principles. o Federal and state goals and objectives related to the implementation of Restricted Recipient Program. o Federal and state laws and rules governing Restricted Recipient Program and other DHS contracted entities. o Medicare program and how it interacts with the Medicaid program. o Medical Assistance, MinnesotaCare, Managed Care Organization, and Consolidated Chemical Dependence Treatment Fund. o Minnesota Medicaid Information System (MMIS) and the Data Warehouse. o Minnesota Medicaid claims processing and coding systems. • Develop and maintain a compliance system. • Ensure that all work completed meets legal and contractual obligations. • Leading and managing the scope of audits. • Write clearly and effectively to broad audiences. • Speak clearly, confidently, and concisely in both large and small group settings. • Effective in managing workload and deadlines. • Able to demonstrate strong investigative, analytical, problem solving, and organizational skills with the ability to produce and measure performance and results. • Working knowledge of Microsoft Word, Excel, Adobe, and basic computer programs. • Knowledge of data and systems used in utilization management and restricted recipient program environments. • The ability to format, analyze, and prepare computer generated reports containing narrative and numeric data. • Provide education, clarification, and interpretations on MRRP policy to staff. • Respond and adapt to changes in priorities, operations, policies, procedures, laws, and rules within a minimal time frame. • 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. 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 job information line 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 this position, contact Carolyn Rice at carolyn.rice@state.mn.us or 651-###-#### . 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 Carolyn Rice at carolyn.rice@state.mn.us . About Human Services Dept (Include brief description of agency -- limit to two sentences) Working together to improve the state we love. What do Minnesota's 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, you'll 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 < Remove this bullet if this position is not eligible for 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 job information line at 651-259-3637 or email careers@state.mn.us and let us know the support you need.