Interest Bidders: Please have an updated resume ready to submit to the hiring supervisor/manager when requested. June 1st, 2025, this position will have a flexible work arrangement that allows for up to 50% telework with a minimum of 50% working in our office per month. Approximately, 5% travel.

This position exists to direct the onsite screening of health care vendors enrolled or enrolling as Minnesota Health Care Program (MHCP) providers; and will advise Office of Inspector General’s (OIG) Program Integrity Oversight Division (PIO) management on the onsite screening standards and processes required for compliance with state and federal law. In this position, the supervisor will: • Direct employee activity to meet federal and state onsite screening requirements; • Develop, implement and maintain the Department of Human Services (DHS) process for reviewing and sanctioning high and moderate risk providers who fail to comply with enrollment, service and/or billing standards; • Develop, implement, and maintain the DHS process for determining the risk levels for provider types; and • Coordinate between Medicaid Provider Audits and Investigations (MPAI), Managed Care Organizations (MCO) and DHS Provider Eligibility and Compliance (PEC) in identifying the standards of enrollment, assessing provider risk levels and the development of a method for reporting findings and/or sanctioning providers.

**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: o 1+ year of experience identifying issues, goals and strategic actions o 100+ hours per year time commitment AND Three (3) years of professional work experience reviewing and providing recommendations for enrollment requirements. Experience must demonstrate the following: • Knowledge and experience in the health care investigatory process. • Develop and implement policies and procedures to review data analysis, algorithms, and computer-generated exception reports of providers. • Direct and train employees to conduct site visits as required by state and federal law.

• Knowledge of the following: o Minnesota Health Care Programs in regard to provider services and enrollment requirements. o Minnesota state statutes, rules and policies pertaining to the delivery of services to Minnesota Health Care Program recipients, including services provided through Managed care organizations (MCOs). o Federal oversight authority of the Medicaid program, as it relates to both Fee-for-Service (FFS) and MCO, and an understanding of the State’s role in enrolling providers in Medicaid to assure compliance with federal mandates. o Local human service agencies, state welfare systems and health care delivery systems. o FFS and MCO claims processing and an understanding of billing policies, procedures and documentation standards based on service type. • Demonstrated ability to function as a strategic planner and make accountable management decisions. • A high level of communication skills that demonstrate the ability to communicate effectively, orally and in writing. • Ability to prioritize unit workload and to direct and supervise staff. • A high-level ability to write, review and edit concise, well-written, factual investigative documents which may be used to support legal actions initiated by MPAI or PEC and may become evidence in civil and criminal cases. • Knowledge and experience in State and Federal enrollment and provider screening requirements. • Assess the qualifications of candidates and hire employees to perform job duties to achieve the objectives of the section. • Variety of experiences working effectively with others from different backgrounds and cultures.