Working Title: Medicaid Program Integrity Review Supervisor
Job Class: Human Services Supervisor 2
Agency: Human Services Dept
Job ID : 94385
Location : St. Paul
Telework Eligible : Yes
Full/Part Time : Full-Time
Regular/Temporary : Limited
Who May Apply : Open to all qualified job seekers
Date Posted : 05/21/2026
Closing Date : 06/04/2026
Hiring Agency/Seniority Unit : Human Services Dept / DHS Central Office MMA
Division/Unit : DHS-Central Office / BHDH Behavioral Health Directo
Work Shift/Work Hours : Day Shift / 8:00am to 4:30pm
Days of Work : Monday - Friday
Travel Required : No
Salary Range: $34.11 - $49.39 / hourly; $71,221 - $103,126 / annually
Classified Status : Unclassified
Bargaining Unit/Union : 216 - Middle Management Association/MMA
End Date : 12/01/2027
FLSA Status : Exempt - Executive
Designated in Connect 700 Program for Applicants with Disabilities (https://mn.gov/mmb/careers/diverse-workforce/people-with-disabilities/connect700/) : No
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 is a temporary position with state benefits
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 is an 18-month temporary position (with the possibility of extension) that leads a team of temporary Medicaid Program Integrity Review Specialists. The team reviews behavioral health services billed to Medicaid to make sure claims are accurate and meet program requirements. Services reviewed include Adult Rehabilitative Mental Health Services (ARMHS), Intensive Residential Treatment Services (IRTS), Peer Services, and Assertive Community Treatment (ACT).
As supervisor, you will guide your team's day-to-day work, answer questions about policy and clinical standards, and make sure reviews are done consistently and on time. You will also be the main point of contact between the review team and DHS policy experts and Behavioral Health Administration (BHA) leadership.
This work helps protect Minnesota's Medicaid program and ensures public funds are used appropriately.
Key responsibilities will include:
Supervise and support a team of temporary Program Integrity Review Specialists, helping them complete prepayment reviews, focused claims reviews, and provider recertification reviews accurately and on schedule.
Provide guidance on clinical and policy questions - including medical necessity criteria, documentation standards, and program integrity requirements - so the team can make consistent, well-grounded recommendations.
Manage workload across the team, coordinating assignments and adjusting priorities as needed.
Oversee onboarding and ongoing training so team members stay current on behavioral health services, review procedures, and DHS policy changes.
Maintain accurate records of review activities and prepare regular reports on team outputs, trends, and outcomes for program leadership.
Administer applicable labor agreements fairly and support team members in meeting performance expectations through coaching, feedback, and corrective action when needed.
Serve as the primary liaison between the review team and DHS policy staff and BHA leadership.
Minimum Qualifications
To be considered, your resume must clearly describe your experience in the areas below, including the start and end month/year for each position held.
Demonstrated leadership experience
Leadership experience can include:
Experience as a supervisor, lead worker, team leader, project lead.
Completion of a State of Minnesota leadership program (e.g. ELI, L4).
A paid/unpaid position leading a program or chairing a committee (e.g. ERG) - experience must include:
AND
Three (3) years of advanced-level work experience conducting clinical and policy reviews of Medicaid services within a human services program.
This experience must demonstrate:
A solid understanding of behavioral health conditions, treatment approaches, and service delivery for programs such as ARMHS, IRTS, Peer Services, and ACT.
In-depth knowledge of Medicaid program rules, medical necessity criteria, and clinical documentation standards for behavioral health services.
Hands-on experience with program integrity review methods - including prepayment review, focused claims review, and provider recertification review.
Familiarity with audit processes, fraud prevention, and Medicaid program integrity standards.
A basic understanding of healthcare coding and billing as it applies to behavioral health services.
Preferred Qualifications
Variety of experiences working effectively with people from backgrounds and cultures different than one's own.
Strong communication skills - able to explain complex topics clearly, both in writing and in conversation, and to listen and respond openly to team members' questions and concerns.
Knowledge of supervisory practices, including workload management, coaching, performance feedback, and corrective action.
Certification as a Program Integrity Professional (CPIP) or in Healthcare Compliance.
Experience working with Medicaid claims platforms, electronic health record (EHR) systems, or reporting tools.
Ability to identify patterns or trends in review findings that may signal systemic documentation issues or provider compliance concerns.
Additional Requirements
The MinnesotaDepartmentofHumanServices(DHS) will conduct criminalbackgroundchecksonallfinalistsforthis position.Finalistsmustpassthe DHS backgroundcheck.
Employee reference checks will be conducted on all finalists. This may include a review of documentation related to jobperformance.It alsoincludescontact withtheapplicant'sformer employer(s).
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.
