Working Title: Federal Audit Contract Liaison
Job Class: Human Services Program Representative 2
Agency: Human Services Dept
Job ID : 90157
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 : 11/07/2025
Closing Date : 11/20/2025
Hiring Agency/Seniority Unit : Human Services Dept / MAPE DHS Central Office
Division/Unit : Department of Human Services / Office of Inspector General (OIG)-PIO POAI RAC/UPIC Unit
Work Shift/Work Hours : Day Shift / 8:00 a.m. - 4:30 p.m.
Days of Work : Monday - Friday
Travel Required : Yes
Salary Range: $32.40 - $47.76 / hourly; $67,651 - $99,722 / 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 (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 (https://mn.gov/mmb-stat/policies/1422-telework.pdf) 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, 5% travel.
This position will assist in the direction and coordination of federally mandated contractors, such as the Recovery Audit Contractor (RAC), the Unified Program Integrity Contractor (UPIC), and other contractors engaged by the Department to address program integrity issues in Minnesota Health Care Programs (MHCP).
Responsibilities include but are not limited to:
Assist in the management of the scope of the RAC, UPIC, and other contractor audits.
Serve as liaison on contractor matters with providers, provider associations, other Department of Human Services (DHS) divisions and administrations, and federal and state agencies impacted by contractor activities.
Assist in ensuring and enforcing contractor compliance with state and federal regulatory and contractual requirements.
Assist in ensuring the reporting obligations of the contractors according to contract requirements are met and that resulting payments to the contractor are appropriate.
Investigate program integrity related cases which could lead to administrative actions.
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 professional experience with receiving, identifying, and/or conducting a full range of regulatory investigations designed to detect, identify, correct, and/or resolve instances of suspected fraud, waste, and abuse by providers.
AND
Experience must demonstrate the following:
Ability to represent agency program integrity efforts and related policies, rules, and statutes, to contracted vendors, auditors, and agency staff to assure vendor projects.
Recommend the auditing of program areas.
Prepare accurate materials regarding contractor work.
Format, analyze, and prepare computer generated reports and conduct claims analyses.
Preferred Qualifications
Knowledge of the following:
-ICD-10, CPT and HCPCS coding experience and/or certification.
-Federal and state laws and rules governing RACs and UPICs
-Minnesota HealthCare Programs, and specifically Medicaid
-Fee-for-service and managed care programs
-Medicare program and how it interacts with the Medicaid program
-Third party liability and benefit recovery principles
-Minnesota Medicaid Information System (MMIS)and the Data Warehouse
-Minnesota Medicaid claims processing and coding systems
-Analytic tools and data mining to identify Medicaid misbilling, overpayments, and fraud
-Principles and practices of provider audits, program integrity initiatives, health care delivery systems, health care provider roles and responsibilities.
Maintain contact with state licensing boards, law enforcement, county human services agencies, and other state agencies when contractor audits reveal issues relating to professional conduct or patient care.
Provide technical assistance and guidance on DHS policy to the contract administrators, auditors, and claims staff to assure successful audit projects.
Resolve routine disputes between MHCP providers and contractors' staff. Escalate sensitive and/or complex disputes as needed.
Skilled in problem solving and decision-making techniques.
Knowledge and proficiency using Microsoft Word, Excel, and SharePoint.
Effective customer service practices.
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.
