Working Title: Program Integrity Coordinator, Managed Care Organizations (MCOs)
Job Class: Human Services Program Representative 2
Agency: Human Services Dept
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Job ID: 95313
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Location: St. Paul
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Telework Eligible: Yes
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Full/Part Time: Full-Time
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Regular/Temporary: Limited
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Who May Apply: Open to all qualified job seekers
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Date Posted: 07/07/2026
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Closing Date: 07/20/2026
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Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office
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Division/Unit: Department of Human Services (DHS) / Office of Inspector General (OIG)- Program Integrity Oversight (PIO) POAI MCO Unit
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Work Shift/Work Hours: Day Shift / 8:00 a.m. - 4:30 p.m.
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Days of Work: Monday - Friday
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Travel Required: Yes
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Salary Range: $32.97 - $48.60 / hourly; $68,841 - $101,476 / annually
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Classified Status: Unclassified
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Bargaining Unit/Union: 214 - MN Assoc of Professional Empl/MAPE
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End Date: 06/30/2029
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FLSA Status: Nonexempt
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Designated in Connect 700 Program for Applicants with Disabilities: No
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.
**Temporary Unclassified role for approximately three (3) years.
**Approximately, 10% travel.
**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.
Minnesota’s contracted Managed Care Organizations (MCOs) are required by federal rule and as a condition of contracting with the State of Minnesota to conduct a variety of program integrity activities and establish Special Investigations Units (SIUs) that conduct specific activities designed to prevent, detect, and respond to fraud, waste, abuse, and noncompliance with certain contractual or other regulatory requirements that results in improper payments. In turn, the State of Minnesota, through its Office of Inspector General, is required to ensure that MCOs implement and maintain effective integrity programs designed to detect and prevent fraud, waste, and abuse in the Medical Assistance (MA) program.
This Temporary Unclassified position is responsible for proposing, designing, developing, and coordinating critical program integrity, compliance and anti-fraud initiatives across the MCOs and between the Fee-For-Service (FFS) program. This includes multiple program activities designed to improve compliance, accountability and return on investment.
**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.**
Three (3) years of experience in Medicaid program integrity, health care compliance, audits, investigations, or fraud, waste, and abuse (FWA) activities.
AND
Experience must demonstrate the following:
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Knowledge of Minnesota Health Care Programs (MHCP) or other Medicaid programs, including managed care and/or fee-for-service delivery systems.
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Experience analyzing program integrity, compliance, audit, or investigative data and applying relevant laws, policies, and contractual requirements.
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Interpret and apply federal and state laws, regulations, and policies related to Medicaid or other publicly funded health care programs.
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Experience coordinating work with multiple internal and external stakeholders.
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Experience in Microsoft Word and Excel, including the ability to prepare reports, documentation, and/or summaries.
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Experience working with Managed Care Organizations (MCOs), including oversight of contractual program integrity or Special Investigation Unit (SIU) activities.
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Experience with Medicaid fraud referrals, concurrent investigations, or coordination with entities such as MFCU, AGO, CMS, or law enforcement partners.
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Advanced knowledge of Medicaid program integrity laws and regulations, including credible allegation of fraud standards and sanction processes.
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Experience developing or implementing policies, procedures, quality metrics, or oversight processes.
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Experience using data analytics, dashboards, or visualization tools to identify trends, aberrancies, or program integrity risks.
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Knowledge of Minnesota Medicaid claims processing, coding systems, or encounter data.
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Experience providing training, technical assistance, or formal presentations to internal or external stakeholders.
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Project management or continuous improvement experience related to program integrity or compliance initiatives.
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Variety of experiences working effectively with others from different backgrounds and cultures.
This position requires successful completion of the following:
It is the policy of the Department of Human Services that the individual selected for this position successfully complete a background investigation prior to employment, including the following components:
- 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.
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 [email protected]. For additional information about the application process, go to http://www.mn.gov/careers.
If you have questions about the position, contact David Cammack at
[email protected].
If you are an individual with a disability and need an ADA accommodation for an interview, you may contact the Department of Human Services’ ADA Coordinator at 651-431-4945 or DEPARTMENT OF HUMAN
[email protected] for assistance.
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.
What do Minnesota's State employees have in common?
- A sense of purpose in their work
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Connection with their coworkers and communities
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Opportunities for personal and professional growth
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.
- Paid vacation and sick leave
- 12 paid holidays each year
- Low-cost medical, dental, vision, and prescription drug plans
- Fertility care, including IVF
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Diabetes care
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Dental and orthodontic care for adults and children
- 6 weeks paid leave for parents of newborn or newly adopted children
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Pension plan that provides income when you retire (after working at least three years)
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Employer paid life insurance to provide support for your family in the event of death
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Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury
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Tax-free expense accounts for health, dental, and dependent care
- Resources that provide support and promote physical, emotional, social, and financial well-being
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Training, classes, and professional development
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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)
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A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance
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Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
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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. 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 [email protected] and let us know the support you need.
