Back to Jobs search

Provider Eligibility Compliance Specialist - Human Services Program Specialist 1

State of Minnesota • Saint Paul, MN • 3h ago

Working Title: Provider Eligibility Compliance Specialist

Job Class: Human Services Program Specialist 1

Agency: Human Services Dept

Job ID : 90022

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 : 11/04/2025

Closing Date : 11/13/2025

Hiring Agency/Seniority Unit : Human Services Dept / MAPE DHS Central Office

Division/Unit : Health Care Administration / Medicaid Payment and Provider Services

Work Shift/Work Hours : Day Shift / 8:00am - 4:30pm

Days of Work : Monday - Friday

Travel Required : No

Salary Range: $23.98 - $34.69 / hourly; $50,070 - $72,432 / annually

Classified Status : Classified

Bargaining Unit/Union : 214 - MN Assoc of Professional Empl/MAPE

FLSA Status : Nonexempt

Designated in Connect 700 Program for Applicants with Disabilities (https://mn.gov/mmb/careers/diverse-workforce/people-with-disabilities/connect700/) : 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. 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.

This posting will be used to fill multiple vacancies

This position is a Minnesota Health Care Programs (MHCP) Provider Eligibility and Compliance Specialist in the Medicaid Payments and Provider Services (MPPS) Provider Eligibility and Compliance unit interpreting and applying internal, state, and federal requirements for determining the eligibility and enrolling counties, health care providers, provider groups and other health care entities into Minnesota Health Care Programs. The incumbent will report to a supervisor and team leads. This position may interact with a variety of provider @types, and may need to contact various entities for information relating to provider credentials.

Responsibilities include:

Analysis, interpretation and application of internal, state, federal and national requirements for determining the eligibility and enrollment of counties, health care providers, provider groups and other health care entities providing services to enrollees in the Medicaid program.

Monitoring, review and verification of provider information to determine impact on eligibility, @type, and level of reimbursement.

Research and respond to inquiries regarding provider enrollment and compliance with policy, procedures and decisions. Research, draft and analyze findings of ad hoc studies and reports related to PEC policies and activities.

Investigate, review and prepare recommendations for modifications, changes, and edits to systems, operations, policies and procedures.

Minimum Qualifications

Two (2) years advanced administrative support, paraprofessional, or technical experience in a healthcare or social services setting.

Associates degree in related field and one (1) year advanced administrative support, paraprofessional or technical experience in a healthcare or social services setting.

AND

Experience must demonstrate:

Ability to research, compile, gather information and/or communicate with stakeholders

Applying understanding of internal, state, federal and/or national rules, regulations, or procedures

Basics in Microsoft Office programs

Preferred Qualifications

Familiarity with MN Healthcare Programs (MHCP), which includes Medical Assistance (MA), General Assistance Medical Care (GAMC), and/or MinnesotaCare (MNCare).

Understanding of Provider Eligibility and Compliance enrollment process and provider manual.

Experience or understanding of MHCP systems and/or MN-ITS

Ability to participate and demonstrate strong team skills while also able to work independently.

Enrolling individual or organizations into a system or program while verifying other databases or experience utilizing multiple systems at the same time to complete a task.

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.

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.

Similar Jobs

Administrative Coordinator

University of Minnesota - 15th Ave • Minneapolis, MN • 1h ago

Management & Administrative

Apply for Job Job ID370925 LocationTwin Cities Job FamilyAdministration-General Full/Part TimeFull-Time Regular/TemporaryRegular Job Code8208A2 Employee ClassCivil Service Add to Favorite Jobs Email this Job About the Jo...

1h ago

Go to Apply

Admissions Office Coordinator

University of Minnesota - 15th Ave • Minneapolis, MN • 1h ago

Management & Administrative

Apply for Job Job ID370904 LocationTwin Cities Job FamilyLR-Clerical Full/Part TimeFull-Time Regular/TemporaryRegular Job Code1885 Employee ClassAFSCME Unit 6 - Clerical Add to Favorite Jobs Email this Job About the Job...

1h ago

Go to Apply

Customer Service Associate

Walgreens • Lakeville, MN • 3h ago

Management & Administrative

Job Description: Models and delivers a distinctive and delightful customer experience. Registers sales on assigned cash register, provides customers with courteous, fair, friendly, and efficient checkout service. Custome...

3h ago

Go to Apply

State of Minnesota • Saint Paul, MN • 3h ago

Management & Administrative

Working Title: SAEF2 Project Manager Job Class: Grants Specialist Senior Agency: Labor & Industry Dept Job ID : 90020 Location : St. Paul Telework Eligible : Yes Full/Part Time : Full-Time Regular/Temporary : Limited...

3h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.