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Health Care Program Eligibility Auditor / Human Svcs Prog Rep 1

State of Minnesota • Saint Paul, MN • 2h ago

Working Title: Health Care Program Eligibility Auditor

Job Class: Human Services Program Representative 1

Agency: Human Services Dept

Job ID : 93648

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 : 04/17/2026

Closing Date : 04/30/2026

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

Division/Unit : Department of Human Services (DHS) / Program Compliance & Audits HC

Work Shift/Work Hours : Day Shift / 8:00 a.m. - 4:30 p.m.

Days of Work : Monday - Friday

Travel Required : No

Salary Range: $29.25 - $42.94 / hourly; $61,074 - $89,658 / 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 (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.**

This position exists under the Program Compliance and Audits team to conduct eligibility audits and reviews for Minnesota Health Care Programs and other human services programs, including PERM, MEQC, GA, HS, and MSA. The auditor evaluates whether eligibility, enrollment, and payment decisions were made accurately by reviewing case documentation, verifying information, and applying all relevant federal and state regulations, policies, and procedures. The position ensures audit integrity through independent analysis, accurate documentation, and adherence to established audit standards.

Responsibilities include but may not be limited to:

Conduct eligibility audits to determine the accuracy of enrollment, eligibility, and payment decisions using approved audit tools, factual evidence, and applicable regulations.

Conduct case research and verification activities to gather and validate information needed to support accurate audit findings.

Prepare audit documentation, reports, and referrals to ensure accurate recordkeeping and compliance with audit standards.

Participate in continuous process improvement efforts to enhance audit quality and efficiency.

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, day and year for each job held.

Two (2) years professional experience as a health care eligibility worker/specialist.

Experience must demonstrate the following:

Experience monitoring and administrating program requirements in health care eligibility and operations.

Experience working with eligibility technology system such as: MAXIS, METS, MMIS, PRISM, or related system.

Ability to consider multiple pieces of information regarding a recipient and deduce whether or not an eligibility decision made in that case was done correctly, along with being able to provide detailed reasoning for any identified error.

A bachelor's degree in human services, public administration, psychology, social work, public health, education or related field may substitute for one (1) year of professional experience.

Preferred Qualifications

Experience in investigating, auditing, reviewing, analyzing and synthesizing substantially diversified procedures and specialized standards.

Experience with Medicaid.

Vocational education in Public Welfare Financial Worker Diploma or Associated Degree.

Experience conducting case reviews or auditing of Health Care (HC) programs.

Experience determining eligibility for Health Care Programs using MAXIS & METS systems

Knowledge of Minnesota's other public assistance programs, rules & regulations.

Variety of experiences working effectively with others from different backgrounds and cultures.

Additional Requirements

REFERENCE/BACKGROUND CHECKS - DHS will conduct reference checks to verify job-related credentials and a 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.

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