Managed Care Provider Relations Manager jobs in Minnesota

When all employees are embraced, respected and heard, we will build a collaborative, equitable, inclusive and anti-racist culture where everyone thrives.

Working Title: Managed Care Contract Manager
Job Class: Human Services Program Representative 2
Agency: Human Services Dept

• Who May Apply: Open to all qualified job seekers
• Date Posted: 10/25/2023
• Closing Date: 11/07/2023
• Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office
• Division/Unit: Health Care Administration / Purchasing and Service Delivery
• Work Shift/Work Hours: Day Shift / 8:00am - 4:30pm
• Days of Work: Monday - Friday
• Travel Required: No
• Salary Range: $30.55 - $45.02 / hourly; $63,788 - $94,001 / annually
• Classified Status: Classified
• Bargaining Unit/Union: 214 - MN Assoc of Professional Empl/MAPE
• FLSA Status: Nonexempt
• Telework Eligible: Yes
• Designated in Connect 700 Program for Applicants with Disabilities: Yes

Make a difference in the lives of Minnesotans.

The work you’ll do is more than just a job. Join the talented, engaged and inclusive workforce dedicated to creating a better Minnesota.

This position facilitates new and existing health care purchasing strategies and initiatives, along with participating in managed care contract development and negotiations. They will monitor compliance of managed care organizations (MCOs) and provide expertise on managed care policy. As a liaison between the Department of Human Services and the MCOs, this individual will build current and new partner relationships. They will interact and collaborate with a number of policy areas such as eligibility, benefits coverage, rate setting, claims processing, and operations as it relates to managed care policy development, implementation and contract management.

Responsibilities:

• Assist in the development, implementation and maintenance of Prepaid Medical Assistance or County-based purchasing arrangements for the provision of health care services.
• Collaborate with and participate in the Division’s managed care contract development and negotiations related to purchasing strategies and initiatives.
• Monitor compliance of Managed Care Organizations (MCOs) with state, federal and other managed care contractual requirements.
• Support managed care contract initiatives intended to improve performance, accountability and compliance with federal, state and contract-specified requirements.
• Provide training to agency and county staff on how managed care systems function; including managed care contractual requirements and policy changes.

Minimum Qualifications

Three (3) years of professional experience working with health care, health administration, social services, human services or a related field demonstrating the following:

• Compliance with State & Federal laws and regulations governing managed care and health care.
• Health care administration, health care policy, managed care, law or directly-related field.
• Contract management.
• Knowledge of County organization structure and the role it plays in eligibility, health care, and continuing care.

***Bachelor’s Degree in Health Policy or related field may substitute for 1 year of experience OR Master’s degree in Health Policy or related field may substitute for 2 years of experience***

Preferred Qualifications

• Experience with Minnesota Health Care Programs, Medicaid, managed care policy, and state and federal laws and regulations that govern managed care.
• Knowledge of Medicare Program, health care purchasing, rates development, cost sharing, quality assurance and quality management principles, and health care provider roles and responsibilities is preferred.
• Experience with monitoring or ensuring contract compliance.
• Well-developed verbal and written communication skills.
• Variety of experiences working effectively with others from different backgrounds and cultures.

Additional Requirements

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.

How to Apply

Select “Apply for Job” at the top of this page. If you have questions about applying for jobs, contact the job information line at 651-259-3637 or email careers@state.mn.us. For additional information about the application process, go to http://www.mn.gov/careers.

If you have questions about the position, contact Chris Gibson at chris.gibson@state.mn.us

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 Kelly Ellich at kelly.ellich@state.mn.us.

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 DHS_ADA@state.mn.us for assistance.

About Human Services Dept

WE MAKE A DIFFERENCE! The Minnesota Department of Human Services impacts the lives of 1.7 million people every year, helping them meet their basic needs so they can achieve their highest potential.

Why Work for Us

Diverse Workforce

We are committed to continually developing a workforce that reflects the diversity of our state and the populations we serve. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve the people of Minnesota.

A recent engagement survey of State of Minnesota employees found:

• 95% of employees understand how their work helps achieve their agency’s mission
• 91% of employees feel trusted to do their jobs
• 88% of employees feel equipped to look at situations from other cultural perspectives when doing their job
• 87% of employees report flexibility in their work schedule

Comprehensive Benefits

Our benefits aim to balance four key elements that make life and work meaningful: health and wellness, financial well-being, professional development, and work/life harmony. As an employee, your benefits may include:

• Public pension plan
• Training and professional development
• Paid vacation and sick leave
• 12 paid holidays each year
• Paid parental leave
• Low-cost medical and dental coverage
• Prescription drug coverage
• Vision coverage
• Wellness programs and resources
• Employer paid life insurance
• Short-term and long-term disability
• Health care spending and savings accounts
• Dependent care spending account
• Tax-deferred compensation
• Employee Assistance Program (EAP)
• Tuition reimbursement
• Federal Public Service Student Loan Forgiveness Program

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.

AN EQUAL OPPORTUNITY EMPLOYER

Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. 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 careers@state.mn.us and indicate what assistance is needed.