Project Manager - Medicaid Program… at Minnesota… · Saint Paul

Summary: The Minnesota Department of Human Services is seeking a Project Manager for the Medicaid Program Integrity. This role involves coordinating efforts related to Medicaid Program Integrity and ensuring compliance with CMS requirements, while also providing strategic oversight and managing program integrity initiatives.

Responsibilities:
- Coordinate all efforts across the execution Aging and Disability Services Administration (ADSA) as it relates to Medicaid Program Integrity
- Provide strategic oversight, operationalizing and coordinating the work across ADSA and DHS related to strengthening program integrity in Medicaid
- Coordinate, track, and ensure that all ADSA-assigned requirements from the Centers for Medicare and Medicaid Services (CMS) through the Corrective Action Plan, focused reviews or audits, and other related activities are completed on-time and in-scope
- Guide and manage the portfolio, track work progress, elevate issues, resolve problems, identify gaps and risks, and collaborate across the Department to ensure effective implementation

Required Qualifications:
- 1 year professional experience in project planning and operations OR 3 years advanced technical or paraprofessional experience
- Bachelor's degree in Human Services, Public Policy, Public Administration or related field and 2 years of advanced technical or paraprofessional experience
- Master's degree in Human Services, Public Policy, Public Administration or related field
- Familiarity with Medicaid program rules, functional eligibility, person-centered support planning, and medical necessity concepts
- Program development and planning
- Awareness of audit processes, fraud prevention, and program integrity standards in Medicaid
- Familiarity with healthcare coding and billing basics relevant to behavioral health services

Preferred Qualifications:
- Knowledge of HIPAA, state data practices, and confidentiality requirements for handling sensitive health information
- Understanding of aging and disability services in scope for the CMS corrective action plan, CMS focused reviews, and other CMS-related activities
- Effective written communication to document findings clearly and professionally
- Proficient computer skills for data entry and electronic documentation systems
- Variety of experiences working effectively with others from different backgrounds and/or cultures

Required Skills: Medicaid program rules, Functional eligibility, Person-centered support planning, Medical necessity concepts, Program development and planning, Audit processes, Fraud prevention, Program integrity standards in Medicaid, Healthcare coding, Healthcare billing, HIPAA, State data practices, Confidentiality requirements for health information, Data entry, Electronic documentation systems, Effective written communication

Benefits: 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, Diabetes care, Dental and orthodontic care for adults and children, 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 to provide support for your family in the event of death, Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury, Tax-free expense accounts for health, dental, and dependent care, Resources that provide support and promote physical, emotional, social, and financial well-being, Training, classes, and professional development, Tuition reimbursement, Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program., Employee Assistance Program (EAP) for work/life support, A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance, Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues, Daily Living/Convenience Services: Chore services, home repair, trip planning, child/elder care, Telework Eligible: Yes