Remote Provider Integrity Leader for Medicaid LTSS

Minnesota Department of Human Services; Saint Paul (MN); Hybrid; USD 87,000 - 125,000; Full time

Benefits offered by this job

Paid vacation and sick leave

12 paid holidays

Pension plan

Employer paid life insurance

Disability insurance

Tax-free expense accounts

Training and professional development

Job summary

The Minnesota Department of Human Services is seeking a Provider Integrity Manager to lead ADSA's statewide Medicaid LTSS integrity program. You will plan, implement, and evaluate strategies to prevent fraud, waste, and abuse while coordinating a multidisciplinary team of 19 FTEs.

This executive role requires deep knowledge of Medicaid LTSS policies, provider standards, and complex data analysis to inform policy and system improvements. Strong collaboration with DHS divisions is essential.

Qualifications

• 4 years of professional work experience with Medicaid LTSS, provider oversight, compliance or program integrity.
• Experience with Medicaid LTSS policies, provider standards, or program requirements.
• Leading or supporting compliance, audit, monitoring or payment integrity work.
• Using data or findings to identify risks and inform decisions.
• Working with Medicaid claims, authorization, provider, provider enrollment or eligibility systems.
• Communicating complex findings and recommendations to leadership, staff, or external partners.

Responsibilities

• Manage and direct ADSA's statewide provider integrity program for Medicaid LTSS.
• Plan, implement, evaluate, and continuously improve provider fraud, waste, and abuse prevention and monitoring.
• Direct a multidisciplinary Provider Integrity Team of 19 FTEs.
• Provide strategic oversight to coordinate unit activities across functions.
• Leverage data and findings to drive policy, system, and operational improvements.

Skills

Leadership experience

Medicaid LTSS knowledge

Data analysis

Communication of findings

Job description

The Minnesota Department of Human Services is seeking a Provider Integrity Manager to lead ADSA's statewide Medicaid LTSS integrity program. You will plan, implement, and evaluate strategies to prevent fraud, waste, and abuse while coordinating a multidisciplinary team of 19 FTEs.

This executive role requires deep knowledge of Medicaid LTSS policies, provider standards, and complex data analysis to inform policy and system improvements. Strong collaboration with DHS divisions is essential.