Behavioral Health Program Integrity & Continuity of Care Manager - Human Services Manager 1

State of Minnesota; Saint Paul (MN); Remote; USD 87,000 - 125,000; Full time

Benefits offered by this job

Telework eligible

Flexible work hours

Job summary

State of Minnesota is seeking a Behavioral Health Program Integrity & Continuity of Care Manager in Saint Paul. This role leads three units overseeing Medicaid program integrity, continuity of care, and payment integrity to prevent fraud and ensure access to medically necessary care.

The incumbent directs multi-unit teams, reports to the Deputy Assistant Commissioner, and ensures compliance with CMS requirements while aligning with enterprise priorities.

Qualifications

• Leadership experience in supervising programs or teams.
• Four years of in-depth knowledge of Medicaid program integrity and continuity of care interventions.
• Understanding of Medicaid statutory and regulatory frameworks for behavioral health programs.
• Experience with Medicaid payment integrity methodologies and data analytics.
• Experience developing policies, directives, and instructions.

Responsibilities

• Provide managerial leadership to three subordinate supervisors and units; establish organizational structures and workflows.
• Lead section planning and contribute to BHA strategic planning with policy recommendations.
• Direct Medicaid payment integrity operations and ensure compliance with CMS requirements.
• Represent BHA in inter-agency fraud prevention and coordinate with DHS administrations.
• Partner with data analytics to define metrics and oversee emergency provider transitions.

Skills

Leadership experience

Supervisory experience

Policy analysis

Cross-agency collaboration

Project management

Communication skills

Job description

Working Title: Behavioral Health Program Integrity & Continuity of Care Manager

Job Class: Human Services Manager 1

Agency: Human Services Dept

• Job ID : 97987

• 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 : 10/27/2026

• Closing Date : 11/17/2026

• Hiring Agency/Seniority Unit : Human Services Dept / DHS Manager

• 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 : Yes, (20% for meetings)

• Salary Range: $41.58 - $60.10 / hourly; $86,819 - $125,488 / annually

• Classified Status : Classified

• Bargaining Unit/Union : 220 - Manager/Unrep

• FLSA Status : Exempt - Executive

• 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.

Flexible work hours may be permitted with supervisor approval.

This position exists to provide managerial leadership, strategic direction, and operational management for the Program Integrity & Continuity of Care Section within the Behavioral Health Administration (BHA), reporting directly to the Deputy Assistant Commissioner, BHA. The incumbent directs BHA’s Medicaid program integrity, payment integrity, and continuity of care functions by providing management to three subordinate supervisory units: a temporary Program Integrity review unit (supervised by a Human Services Supervisor 2) and two permanent operational units—Medicaid Payment Integrity and Medicaid Program Integrity & Continuity of Care (each supervised by a proposed Human Services Supervisor 3).

The position governs a multi-tiered operational framework (encompassing work direction leads, policy analysts, compliance trainers, program specialists, and administrative intake support) to build a robust fraud-prevention infrastructure that stops Medicaid improper payments before and after disbursement. Concurrently, the incumbent directs the statewide administration of statutory continuity of care mandates under Minn. Stat. §§ 256B.045 and 256B.046, ensuring BHA meets its legal obligations to protect recipient welfare and maintain seamless access to medically necessary care when behavioral health providers face serious operational events or complex transitions. The manager is accountable for section-wide resource allocation, section planning, recommending policy changes to BHA program areas and leadership, and ensuring program operations align with enterprise priorities, federal Centers for Medicare & Medicaid Services (CMS) requirements, and inter-administration oversight protocols across DHS.

Duties include, but not limited to:

• Provide managerial leadership, operational governance, and supervisory direction to three subordinate supervisors and their multidisciplinary units; establish tiered organizational structures, workforce plans, and managerial controls that drive high performance, balance workloads, and ensure compliance with employer policies and statewide collective bargaining agreements.

• Lead section planning and contribute to BHA strategic planning as a member of the BHA leadership team, share program integrity and continuity of care findings with BHA program areas and recommend policy changes, and direct BHA’s operational implementation and administration of statutory continuity of care and serious operational event mandates under Minn. Stat. §§ 256B.045 and 256B.046, safeguarding vulnerable recipients from service disruptions during provider closures or insolvencies.

• Direct section-wide Medicaid payment integrity operations, claims review governance, and fiscal resource management; oversee prepayment review and CMS-directed focused review of questionable claims to safeguard nearly $1 billion in annual Medicaid behavioral health expenditures against fraud, waste, and improper payments.

• Serve as BHA’s senior representative in inter-agency fraud prevention, cross-divisional program integrity governance, and high-level stakeholder negotiations; oversee BHA’s mandatory compliance training for owners and managers of BHA high-risk provider types, coordinating with other DHS administrations that train their own provider types.

• Partner with the BHA data analytics team, which produces the section’s data analysis and dashboards, to define performance metrics, quality measures, and risk trends, and use the results to report to executive leadership; manage emergency provider transitions and ad hoc executive directives issued by the Deputy Assistant Commissioner or Assistant Commissioner. Overseeing the hiring of staff; mentoring and supervising staff who are designing and implementing complex work plans.

All DHS Leaders are expected to demonstrate and develop the five (5) competency themes from the Enterprise-wide Leader Competency Model:

• Leading Self

• Leading Others

• Leading the Organization

• Leading Outside the Organization

• Getting Work Done

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.

Demonstrated leadership experience*

*Leadership experience can include:

• Experience as a supervisor, lead worker, team lead, 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:

• 1+ year of experience identifying issues, goals, and strategic actions.

• 100+ hours per year time commitment

AND

Four (4) years of in-depth knowledge of Medicaid program integrity and continuity of care interventions, and care development demonstrating the following:

• High-level understanding of State and federal Medicaid statutory and regulatory frameworks, specifically Title XIX, federal CMS program integrity standards, and Minnesota statutes governing behavioral health programs.

• Practical understanding of program standards, clinical documentation criteria, coverage policies, and medical necessity definitions for Mental Health Programs such as, ARMHS, ACT, IRTS, and Substance Use Programs such as Residential, Outpatient and Peer Recovery Services.

• Experience with Medicaid payment integrity methodologies, including data analytics, prepayment review, focused claims review, and fraud/waste/abuse detection.

• Experience analyzing complex claims data, audit results, and provider trends to identify systemic vulnerabilities and translate them into recommendations for program areas and leadership.

• Practical understanding program management and continuous improvement process to produce and track measurable results.

• Experience with developing polices, directives, and/or instructions.

Preferred Qualifications

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

• Strong human relations and communication skills; communicate clearly and professionally both verbally and in writing; respond openly to requests and concerns.

• Adult learning theory, curriculum design, and provider compliance training models.

• Analyzing complex claims data, audit results, and provider trends to identify systemic vulnerabilities and translate them into recommendations for program areas and leadership.

• Experience with high-stakes negotiation, dispute mediation, and consensus building among diverse regulatory, county, Tribal, and provider stakeholders.

• Experience leading cultural and organizational change while supporting the professional growth of diverse supervisory, clinical, and analytical personnel.

• Knowledge of laws and administrative procedures sufficient to serve as a policy and technical expert before legislative policy committees and other public forums.

• Understanding of organizational change processes and systems transformation frameworks.

• Creative and efficient problem solver able to address a complex range of policy, clinical management, and systems issues.

Additional Requirements

• MinnesotaDepartmentofHumanServices(DHS)criminalbackgroundcheckwillbeconductedonallfinalistsforthis position.Finalistsmustpassthe DHS backgroundcheck.

• Employee reference checks will be conducted on all finalists. This may include a review of documentation related to job performance.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 [e-mail] . Please indicate what assistance is needed.