Health Care Program Eligibility Auditor / Human Svcs Prog Rep 1

Job Details

Working Title: Health Care Program Eligibility Auditor
Job Class: Human Services Program Representative 1
Agency: Human Services Dept

• Job ID: 93648
• 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: 04/17/2026
• Closing Date: 04/30/2026
• Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office
• Division/Unit: Department of Human Services (DHS) / Program Compliance & Audits HC
• Work Shift/Work Hours: Day Shift / 8:00 a.m. - 4:30 p.m.
• Days of Work: Monday - Friday
• Travel Required: No
• Salary Range: $29.25 - $42.94 / hourly; $61,074 - $89,658 / 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.***

This position exists under the Program Compliance and Audits team to conduct eligibility audits and reviews for Minnesota Health Care Programs and other human services programs, including PERM, MEQC, GA, HS, and MSA. The auditor evaluates whether eligibility, enrollment, and payment decisions were made accurately by reviewing case documentation, verifying information, and applying all relevant federal and state regulations, policies, and procedures. The position ensures audit integrity through independent analysis, accurate documentation, and adherence to established audit standards.

• Conduct eligibility audits to determine the accuracy of enrollment, eligibility, and payment decisions using approved audit tools, factual evidence, and applicable regulations.
• Conduct case research and verification activities to gather and validate information needed to support accurate audit findings.
• Prepare audit documentation, reports, and referrals to ensure accurate recordkeeping and compliance with audit standards.
• Participate in continuous process improvement efforts to enhance audit quality and efficiency.

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.**

Two (2) years professional experience as a health care eligibility worker/specialist.

Experience must demonstrate the following:

• Experience monitoring and administrating program requirements in health care eligibility and operations.
• Experience working with eligibility technology system such as: MAXIS, METS, MMIS, PRISM, or related system.
• Ability to consider multiple pieces of information regarding a recipient and deduce whether or not an eligibility decision made in that case was done correctly, along with being able to provide detailed reasoning for any identified error.

A bachelor’s degree in human services, public administration, psychology, social work, public health, education or related field may substitute for one (1) year of professional experience.

Preferred Qualifications

• Experience in investigating, auditing, reviewing, analyzing and synthesizing substantially diversified procedures and specialized standards.
• Experience with Medicaid.
• Vocational education in Public Welfare Financial Worker Diploma or Associated Degree.
• Experience conducting case reviews or auditing of Health Care (HC) programs.
• Experience determining eligibility for Health Care Programs using MAXIS & METS systems
• Knowledge of Minnesota's other public assistance programs, rules & regulations.
• 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 careers@state.mn.us. For additional information about the application process, go to http://www.mn.gov/careers.

Contact

If you have questions about the position, contact Gary Johnson at gary.l.johnson@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 Carolyn Rice at carolyn.rice@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.

Working together to improve the state we love.

What do Minnesota's State employees have in common?

• A sense of purpose in their work
• Connection with their coworkers and communities
• Opportunities for personal and professional growth

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.

EQUAL OPPORTUNITY EMPLOYERS

Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. State agencies are committed to creating a workforce that reflects the diversity of the state and strongly encourages persons of color and Indigenous communities, members of the LGBTQIA2S+ community, individuals with disabilities, women, and veterans to apply. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve Minnesotans.

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, sex (including pregnancy, childbirth, and disabilities related to pregnancy or childbirth), gender identity, gender expression, marital status, familial status, age, sexual orientation, status regarding public assistance, disability, veteran status or activity in a local Human Rights Commission or any other characteristic protected by law.

APPLICANTS WITH DISABILITIES

Minnesota state agencies make reasonable accommodations to their employees and applicants with disabilities. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at 651-259-3637 or email careers@state.mn.us and let us know the support you need.