Lead Program Eligibility Auditor - Human Services Program Representative 2

Minnesota Department of Veterans Affairs

• $68K — $101K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 3 years of experience in program eligibility and/or auditing.
  • Experience with MAXIS, METS, MMIS, and PRISM data management tools.
  • Proficient in Microsoft Office applications.
  • Bachelor's degree in relevant fields may substitute for 1 year of experience.
  • Master's degree in relevant fields may substitute for 2 years of experience.

Responsibilities

  • Conduct eligibility reviews as a first or second quality assurance.
  • Perform medical record and claim error reviews for the Payment Error Rate Measure.
  • Develop and revise dashboard performance reports for Program Compliance and Audits.
  • Create and update orientation program documents for the auditing team.
  • Annually revise the eligibility review team’s reviewer manual to reflect regulatory changes.

Benefits

  • Paid vacation and sick leave.
  • 12 paid holidays each year.
  • Affordable health, dental, vision, and prescription plans including maternity and chronic care.
  • 6 weeks paid leave for new parents.
  • Pension plan for retirement income.
Full Job Description
Job Details

Working Title: Lead Program Eligibility Auditor
Job Class: Human Services Program Representative 2
Agency: Human Services Dept
  • Job ID: 97283
  • 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: 09/25/2026
  • Closing Date: 10/08/2026
  • Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office
  • Division/Unit: DHS-Central Office / Program Compliance & Audits HC
  • Work Shift/Work Hours: Day Shift, 8:00am - 4:30pm
  • Days of Work: Monday - Friday
  • Travel Required: No
  • Salary Range: $32.97 - $48.60 / hourly; $68,841 - $101,476 / annually
  • Classified Status: Classified
  • Bargaining Unit/Union: 214 - MN Assoc of Professional Empl/MAPE
  • FLSA Status: Nonexempt
  • Designated in Connect 700 Program for Applicants with Disabilities : Yes

The Department of Human Services is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DHS does not participate in E-Verify.

The work you'll do is more than just a job.

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.

Job Summary

***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.***

The Lead Program Eligibility Auditor supports the Program Compliance and Audits Manager and Supervisor, acting as their liaison when they cannot be present. The incumbent will report information to management that is relevant to maintaining an efficient and productive work environment. This role also exists to provide a first line resource person for the program eligibility auditors on their team, functioning as a decision maker when two auditors do not agree on an audit finding, an educator when an auditor is unclear on an audit process, relevant policy/regulation or audit procedure, an issue/question escalator when necessary and a subject matter expert (SME) on the audit their team is conducting.

Responsibilities include but may not be limited to:
  • Conduct eligibility reviews (first or second QA).
  • Conduct medical record & claim error reviews that are a component of the Payment Error Rate Measure (PERM) Review.
  • Develop, implement, generate and revise as necessary dashboard performance reports for Program Compliance and Audits.
  • Develop, implement, generate and revise as necessary orientation program documents for Program Compliance and Audits.
  • Annually update/revise Eligibility review team's reviewer manual, incorporating federal and state regulatory changes, audit form use updates, reviewer tool use updates, etc.


Qualifications

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, day and year for each job held.**

Three (3) years of experience in program eligibility and/or auditing.

Experience must also demonstrate:
  • Monitoring and administrating program requirements for eligibility.
  • Investigating, auditing, reviewing, and analyzing diversified procedures and standards.
  • Experience working with MAXIS, METS, MMIS and PRISM or other relateddata management tools and procedures such as input, collection and retrieval systems.
  • Experience with Microsoft Office applications.

*A Bachelor's degree in Public Health, Health and Human Services, public policy, or another related degree field may substitute for one (1) year of professional experience.

OR

**A Master's degree in Public Health, Health and Human Services, public policy, or another related degree field may substitute for two (2) years of experience.

Preferred Qualifications
  • Experience in Healthcare program eligibility or auditing.
  • Experience as a lead worker in program eligibility, auditing, or a related field.
  • Working knowledge of Minnesota's Health Care and other eligibility programs, regulations, policies and determinations.
  • Variety of experiences working effectively with others from different backgrounds and cultures.

Additional Requirements

REFERENCE/BACKGROUND CHECKS - DHS will conduct reference checks to verify job-related credentials and a criminal background check prior to appointment.

Application Details

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 [email protected] . For additional information about the application process, go to http://www.mn.gov/careers .

Contact

If you have questions about this position, contact Monica Templin at [email protected] .

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 Alexander Duren 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 [email protected] for assistance.

Benefits

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.

Your benefits may include:
  • 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

Support to help you reach your career goals:
  • Training, classes, and professional development
  • 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 )

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


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.

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