Medicaid Payments Program Integrity and Systems Coordinator / Human Services Program Consultant

Minnesota Direct Care and Treatment; Saint-Paul; On-site; CAD 107,000 - 158,000; Full time

Benefits offered by this job

Paid vacation and sick leave

12 paid holidays

Low-cost medical, dental, vision, and药

Job summary

The Minnesota Department of Human Services seeks a Medicaid Payments Program Integrity and Systems Coordinator to lead guidance, prioritization, planning, and oversight of payment system maintenance and modernization across multiple Medicaid program areas.

The role ensures alignment with federal and state policies and collaborates with business architects, developers, and IT project leads to deliver compliant solutions.

Qualifications

• Thorough understanding of Minnesota Health Care Programs.
• Knowledge of Medicaid policy, systems, benefits, and service delivery to understand how multiple systems operate and interact.
• Ability to organize and manage a broad spectrum of constituencies while addressing complex health care payment policies and goals.
• Knowledge of DHS policies, procedures, and protocol for handling state legislative responsibilities and submitting documents for legislative application.
• Ability to apply technical expertise in Medicaid and related state and federal laws, policies, and regulations.
• Ability to monitor, analyze, and advise on trends and developments related to payment policy.
• Strong oral and written communication skills.

Responsibilities

• Provide strategic and tactical guidance, support, and oversight of Medicaid payment activities and projects.
• Develop, direct and coordinate implementation of MHCP program integrity and compliance policies and directions.
• Partner with DHS HCA, OIG and MFCU to set strategies for MPPS and oversee the claims payment system.

Skills

Medicaid policy

Health care programs

Systems knowledge

Policy compliance

Communication skills

Stakeholder management

Job description

Telework Eligible: Yes

Working Title: Medicaid Payments Program Integrity and Systems Coordinator

Job Class: Human Services Program Consultant

Agency: Human Services Dept

• Job ID: 96921
• 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: 09/10/2026
• Closing Date: 09/23/2026
• Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office
• Division/Unit: DHS-Central Office / HCA MPPS Claims Ops Integrity
• Work Shift/Work Hours: Day Shift
• Days of Work: Monday - Friday
• Travel Required: No
• Salary Range: $36.59 - $54.25 / hourly; $76,399 - $113,274 / annually
• Classified Status: Classified
• Bargaining Unit/Union: 214 - MN Assoc of Professional Empl/MAPE
• FLSA Status: Exempt - Administrative
• Designated in Connect 700 Program for Applicants with Disabilities: Yes

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.

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.

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 exists to provide advanced professional knowledge as a business owner and coordinator to provide guidance, prioritize, plan, lead, and support Medicaid’s efforts for its payment system maintenance, operations, development and implementation for multiple business areas within the Medicaid program so that it meets the needs of a wide variety of stakeholders. The person in this role serves as a Medicaid payments policy content expert and speaks on behalf of his/her administration in interactions with business architects, developers and other IT project leads to ensure that IT staff clearly understand their business, including its policies, programs and clientele and have timely information necessary to successfully maintain, operate, develop and modernize the claims payment IT system. He/she ensures compliance with federal and state policies, laws and regulations necessary to implement Medicaid program requirements.

This Position Will

• Provide strategic and tactical guidance, support, and oversight of Medicaid payment activities and projects by developing, updating and implementing activities as they relate to system, policy, procedural or operational changes that occur as a result.
• Develop, direct and coordinate implementation of MHCP program integrity and compliance policies and directions to ensure systems and operational procedures are compliant with all relevant federal and state statutes and regulations.
• Partner with DHS HCA, OIG and MFCU to set strategies for, develop, implement and oversee MPPS business unit efforts and claims payment system to apply pre-payment review activity in an effort to prevent of fraud, waste and abuse within the MHCP programs. Act as a subject matter expert on various complex issues and interactions among health care and other related programs

MPPS operationalizes systems and policies necessary to process payment transactions for services provided through a wide array of programs and for external systems that utilize the data or information stored within the systems operated by the business units.

Minimum Qualifications

• Thorough understanding or ability to develop expertise in Minnesota Health Care Programs in a short time-frame
• Knowledge and experience with Medicaid policy, systems, benefits, and service delivery sufficient to understand how multiple computer systems operate, interact, and interface so that solutions are identified and system design problems are resolved
• Ability to organize and manage a broad spectrum of constituencies while addressing complex health care payment policies and goals
• Knowledge of and ability to adhere to DHS' policies, procedures, and protocol for handling its state legislative responsibilities and submitting documents for legislative application
• Ability to apply technical expertise in and extensive knowledge base relating to Medicaid and associated state and federal laws, policies, and regulations
• Ability to monitor, analyze, and advise on trends and developments related to payment policy
• Strong oral and written communication skills

Preferred Qualifications

• Strategic planning and organization skills
• Problem solving ability that uses a logical, sequential approach
• Decision making
• Planning, organization, and time management skills
• Variety of experiences working effectively with others from different backgrounds and/or 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.

About Human Services Dept

WE MAKE A DIFFERENCE! The Minnesota Department of Human Services impacts the lives of 1.7 million people every year, helping them meet their basic needs so they can achieve their highest potential.

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
• 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.