Managed Care Organization; MCO) Program Integrity Consultant​/Human Services Program Representative

Position: Managed Care Organization (MCO) Program Integrity Consultant /Human Services Program Representative 2
*
* Working Title:

Managed Care Organization (MCO) Program Integrity Consultant*
* ** Job Class:
Human Services Program Representative 2*
* ** Agency:
Human Services Dept*
* +  
** Job ** : 97034

+  
** Location** :
St. Paul

+  
** Telework Eligible** :
Yes

+  
** Full/Part Time** :
Full-Time

+  
** Regular/Temporary** :
Limited

+  
** Who May Apply** :
Open to all qualified job seekers

+  
** Date Posted** : 09/15/2026

+  
** Closing Date** : 09/28/2026

+  
** Hiring Agency/Seniority Unit** :
Human Services Dept / MAPE DHS Central Office

+  
** Division/Unit** :
Department of Human Services (DHS) / Office of Inspector General (OIG)-PIO POAI MCO Unit

+  
** Work Shift/Work Hours** :
Day Shift / 8:00 a.m.

- 4:30 p.m.

+  
** Days of Work** :
Monday - Friday

+  
** Travel Required** :
Yes

+  
** Salary Range:**  $32.97 - $48.60 / hourly; $68,841 - $101,476 / annually

+  
** Classified Status** :
Unclassified

+  
** Bargaining Unit/Union** : 214 - MN Assoc of Professional Empl/MAPE

+  
** End Date** : 10/14/2029

+  
** FLSA Status** :
Nonexempt

+ Designated in Connect 700 Program for Applicants with Disabilities ((Use the "Apply for this Job" box below)./connect
700/) :
Yes

The Department of Human Services (DHS) 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.

** _*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._*
* ** _*Up to 10% travel._*
* 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 (OIG), 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.

Responsibilities of the Temporary Unclassified MCO Program Integrity Consultant include but are not limited to:

+ Plan, design, develop, conduct, and report on results of focused monitoring and auditing of MCO compliance with program integrity requirements, and coordinate compliance and corrective action when deficiencies are identified.

+ Serve as a technical expert on MCO program integrity requirements and compliance monitoring to advise division leadership, propose strategies and coordinate engagements with MCOs.

+ Evaluate and report on MCO compliance with federal rules, Minnesota statute and rules, and Department of Human Services (DHS) policies, and in accordance with their contracts.

+ Serve as a key liaison between the OIG and Program Integrity Oversight Division (PIO) and the MCO SIUs and Restricted Recipient Programs, as well as state and federal partners such as the MN Attorney General's Office, Office of Legislative Auditor, Department of Health, and Centers for Medicaid and Medicare Services.

** 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 and year for each job held.
** _*
* Three (3) years of experience monitoring, auditing and overseeing activities related to program compliance.

Experience must demonstrate the following:

+ Knowledge of health care fraud, waste and abuse, as well as program integrity and anti-fraud initiatives.

+ Assess integrity program effectiveness and recommend solutions.

+ Format, analyze, and/or prepare…