Supervise, train and develop unit staff performing a mix of managed care enrollment, education, evaluation and problem resolution activities specializing in Medicare special needs plans, including:
- Connecting eligible people with reliable medical benefits provided through a managed care organization (MCO) that offers a Medicare special needs plan;
- Reviewing county and managed care organization-produced education and information materials;
- Jointly developing systems, business operations, organizational structures and procedures for enrolling eligible enrollee's into contracted managed care organization's/Medicare special needs plans;
- Developing resources, including policies and procedures, for unit staff in the third party administration unit enrolling seniors and disabled individuals into managed care organizations;
- Ensuring that TPA unit's policies and procedures are compatible with Medicare, Medicaid and managed care organization managed care organization requirements
- Ensuring that needed enrollment eligibility data is available to managed care organization's and contracted providers throughout the state;
- Ensuring timely and accurate enrollment of eligible enrollable individuals, and
- Coordinating with Health Care Operations (HCO), Health Care Eligibility and Operations (HCEO), DHS systems specialists, managed care contract managers, DHS eligibility and operations units, DHS non-Medicare enrollment unit, DHS Managed Care Ombudsman’s office, and CMS staff to resolve managed care enrollment, service access and service delivery problems.
- Supervisory or other leadership experience OR completion of leadership development program (L4, Emerging Leaders Institute, etc.)
Bachelor’s degree in health care administration, business administration or human services or related field may substitute for 1 year of professional experience OR Master’s degree in health care administration, business administration or human services or related field may substitute for 2 years of professional experience.
- Three (3) years managed health care program operations professional experience demonstrating the following:
- Minnesota health care program policy and health care programs expertise.
- Public health care programs, including Medicare and Medicaid eligibility.
- Interpretation and application of data and metrics.
- Contracting experience
- Budget management skills
- Ability to research complicated issues and respond diplomatically to sensitive inquiries from individuals at different levels of authority.
- Working knowledge of MAXIS and/or MMIS systems Knowledge of public benefit programs or related experience.
- Excellent written and oral communication skills.
- Strong analytical and problem resolution skills.
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.
Why Work For Us
GREAT BENEFITS PACKAGE! The State of Minnesota offers a comprehensive benefits package including low cost medical and dental insurance, employer paid life insurance, short and long term disability, pre-tax flexible spending accounts, retirement plan, tax-deferred compensation, generous vacation and sick leave, and 11 paid holidays each year.
This position is located in Minnesota's great capital city, St. Paul. The State of Minnesota offers employees subsidies for public transportation allowing for convenient and easy access to commute to work. Ride the new METRO "Green Line" Light Rail Train to work! The 10th Street Station is located close by.
Our mission as an employer is to actively recruit, welcome and support a workforce, which is diverse and inclusive of people who are underrepresented in the development of state policies, programs and practices, so that we can support the success and growth of all people who call Minnesota home.
How to Apply
Click “Apply” at the bottom of this page. If you have questions about applying for jobs, contact the job information line at 651-259-3637.
For additional information about the application process, go to http://www.mn.gov/careers.
If you have questions about the position, contact Gretchen Ulbee at firstname.lastname@example.org.
If you are a Connect 700 applicant, please email your certificate and the Job posting ID number to Daniel Thorp at email@example.com by the position close date.
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 for assistance.
AN EQUAL OPPORTUNITY EMPLOYER
The State of Minnesota is an equal opportunity, affirmative action, and veteran-friendly employer. We are committed to providing culturally responsive services to all Minnesotans. The State of Minnesota recognizes that a diverse workforce is essential and strongly encourages qualified women, minorities, individuals with disabilities, and veterans to apply.
We will make reasonable accommodations 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 firstname.lastname@example.org. Please indicate what assistance you need.