Minnesota Department of Human Services
Medicaid Provider Audits and Investigations Manager / Human Services Manager 2
Minnesota Department of Human Services, Saint Paul, Minnesota, United States, 55199
Medicaid Provider Audits and Investigations Manager / Human Services Manager 2
Working Title:
Medicaid Provider Audits and Investigations Manager
Job Class:
Human Services Manager 2
Agency:
Human Services Dept
Job Details
Job ID:
90078
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:
11/05/2025
Closing Date:
11/25/2025
Hiring Agency/Seniority Unit:
Human Services Dept / DHS Manager
Division/Unit:
Department of Human Services (DHS) / Office of Inspector General (OIG)-PIO Division Management
Work Shift/Work Hours:
Day Shift / 8:00 a.m. - 4:30 p.m.
Days of Work:
Monday - Friday
Travel Required:
Yes
Salary Range:
$43.38 - $62.41 / hourly; $90,577 - $130,312 / annually
Classified Status:
Classified
Bargaining Unit/Union:
220 - Manager/Unrep
FLSA Status:
Exempt - Executive
Connect 700 Program for Applicants with Disabilities:
Yes
Description Under the general direction of the Deputy Inspector General, this position provides executive leadership and strategic oversight of health care program integrity within Minnesota’s Medicaid system. The incumbent manages anti‑fraud, waste, and abuse efforts, including provider investigations, prevention, education, and enforcement activities.
Responsibilities
Developing and implementing investigative protocols to ensure payment integrity and legitimacy of services provided to public clients.
Strategic planning, policy development, collaboration with federal and state partners, and oversight of case management systems.
Supports legislative and budget initiatives, ensures regulatory compliance, and uses data analytics to guide interventions that enhance care delivery, payment accuracy, and overall Department of Human Services (DHS) performance.
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.
Five (5) years of experience managing investigations and prosecutions related to human services programs and particularly Medicaid or Minnesota Health Care Programs.
Experience must demonstrate the following:
Knowledge of health care issues surrounding fraud and abuse by providers.
Develop compliance, investigative, surveillance, analysis, training models and/or toolsets used to determine trends in fraudulent or abusive provider practices.
Lead continued system development to meet investigative needs and legal requirements.
Develop, implement, evaluate, and alter administrative processes.
Preferred Qualifications
Development of program integrity activities on the local and national levels.
Knowledge of Minnesota's fee-for-service and managed care health care delivery systems, payment mechanisms, and costs.
Understanding of legislative processes, documents and procedures.
Design and implement specific written protocols investigations of all provider types.
Plan and implement policy, program, operations, and budget changes.
Understands the theories behind, policy issues surrounding, and current applications of reimbursement methodologies and systems used to reimburse health care services.
Understand automated systems and data communications technology to support DHS reporting, accountability, and strategic planning activities.
Variety of experiences working effectively with others from different backgrounds and cultures.
Additional Requirements This position requires successful completion of the following:
Background investigation prior to employment, including:
Criminal background check.
Reference check.
Fingerprinting check (MNJIS/CJIS).
Complete the Criminal Justice Information System (CJIS) Security Awareness training within 3 business days from the start of employment; and successfully obtain/retain CJIS certification annually.
How To Apply Select “Apply for Job” at the top of this page. If you have questions about applying for jobs, contact the Careers Help Desk at 651-259-3637 or email careers@state.mn.us. For additional information about the application process, go to
http://www.mn.gov/careers .
Contact: Amanda Novak at amanda.novak@state.mn.us.
To receive consideration as a Connect 700 Program applicant, apply online, email the Job ID#, the Working Title and your valid Proof of Eligibility Certificate by the closing date to Carolyn Rice at carolyn.rice@state.mn.us.
If you are an individual with a disability and need an ADA accommodation for an interview, contact the Department of Human Services’ ADA Coordinator at 651-431-4945 or DEPARTMENT OF HUMAN SERVICES_ADA@state.mn.us for assistance.
Benefits
Paid vacation and sick leave.
12 paid holidays each year.
Low‑cost medical, dental, vision, and prescription drug plans (including fertility care, diabetes care, adult and child dental and orthodontic care).
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.
Short‑term and long‑term disability insurance.
Tax‑free expense accounts for health, dental, and dependent care.
Resources that provide support and promote physical, emotional, social, and financial well‑being.
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 encourage 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. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at 651-259-3637 or email careers@state.mn.us and let us know the support you need.
#J-18808-Ljbffr
Medicaid Provider Audits and Investigations Manager
Job Class:
Human Services Manager 2
Agency:
Human Services Dept
Job Details
Job ID:
90078
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:
11/05/2025
Closing Date:
11/25/2025
Hiring Agency/Seniority Unit:
Human Services Dept / DHS Manager
Division/Unit:
Department of Human Services (DHS) / Office of Inspector General (OIG)-PIO Division Management
Work Shift/Work Hours:
Day Shift / 8:00 a.m. - 4:30 p.m.
Days of Work:
Monday - Friday
Travel Required:
Yes
Salary Range:
$43.38 - $62.41 / hourly; $90,577 - $130,312 / annually
Classified Status:
Classified
Bargaining Unit/Union:
220 - Manager/Unrep
FLSA Status:
Exempt - Executive
Connect 700 Program for Applicants with Disabilities:
Yes
Description Under the general direction of the Deputy Inspector General, this position provides executive leadership and strategic oversight of health care program integrity within Minnesota’s Medicaid system. The incumbent manages anti‑fraud, waste, and abuse efforts, including provider investigations, prevention, education, and enforcement activities.
Responsibilities
Developing and implementing investigative protocols to ensure payment integrity and legitimacy of services provided to public clients.
Strategic planning, policy development, collaboration with federal and state partners, and oversight of case management systems.
Supports legislative and budget initiatives, ensures regulatory compliance, and uses data analytics to guide interventions that enhance care delivery, payment accuracy, and overall Department of Human Services (DHS) performance.
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.
Five (5) years of experience managing investigations and prosecutions related to human services programs and particularly Medicaid or Minnesota Health Care Programs.
Experience must demonstrate the following:
Knowledge of health care issues surrounding fraud and abuse by providers.
Develop compliance, investigative, surveillance, analysis, training models and/or toolsets used to determine trends in fraudulent or abusive provider practices.
Lead continued system development to meet investigative needs and legal requirements.
Develop, implement, evaluate, and alter administrative processes.
Preferred Qualifications
Development of program integrity activities on the local and national levels.
Knowledge of Minnesota's fee-for-service and managed care health care delivery systems, payment mechanisms, and costs.
Understanding of legislative processes, documents and procedures.
Design and implement specific written protocols investigations of all provider types.
Plan and implement policy, program, operations, and budget changes.
Understands the theories behind, policy issues surrounding, and current applications of reimbursement methodologies and systems used to reimburse health care services.
Understand automated systems and data communications technology to support DHS reporting, accountability, and strategic planning activities.
Variety of experiences working effectively with others from different backgrounds and cultures.
Additional Requirements This position requires successful completion of the following:
Background investigation prior to employment, including:
Criminal background check.
Reference check.
Fingerprinting check (MNJIS/CJIS).
Complete the Criminal Justice Information System (CJIS) Security Awareness training within 3 business days from the start of employment; and successfully obtain/retain CJIS certification annually.
How To Apply Select “Apply for Job” at the top of this page. If you have questions about applying for jobs, contact the Careers Help Desk at 651-259-3637 or email careers@state.mn.us. For additional information about the application process, go to
http://www.mn.gov/careers .
Contact: Amanda Novak at amanda.novak@state.mn.us.
To receive consideration as a Connect 700 Program applicant, apply online, email the Job ID#, the Working Title and your valid Proof of Eligibility Certificate by the closing date to Carolyn Rice at carolyn.rice@state.mn.us.
If you are an individual with a disability and need an ADA accommodation for an interview, contact the Department of Human Services’ ADA Coordinator at 651-431-4945 or DEPARTMENT OF HUMAN SERVICES_ADA@state.mn.us for assistance.
Benefits
Paid vacation and sick leave.
12 paid holidays each year.
Low‑cost medical, dental, vision, and prescription drug plans (including fertility care, diabetes care, adult and child dental and orthodontic care).
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.
Short‑term and long‑term disability insurance.
Tax‑free expense accounts for health, dental, and dependent care.
Resources that provide support and promote physical, emotional, social, and financial well‑being.
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 encourage 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. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at 651-259-3637 or email careers@state.mn.us and let us know the support you need.
#J-18808-Ljbffr