Quality Management Lead / Human Services Program Consultant

Quality Management Lead

Job Class: Human Services Program Consultant

Agency: Human Services Dept

Location: St. Paul

Telework Eligible: Yes

Full/Part Time: Full-Time

Regular/Temporary: Unlimited

Who May Apply: Open to all qualified job seekers

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

Division/Unit: Department of Human Services (DHS) / Office of Inspector General (OIG) FFAID QA & OPS

Work Shift/Work Hours: Day Shift / 8:00 a.m. - 4:30 p.m.

Days of Work: Monday - Friday

Travel Required: No

Salary Range: $35.96 - $53.32 / hourly; $75,084 - $111,332 / annually

Classified Status: Classified

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

FLSA Status: Exempt - Administrative

Designated in Connect 700 Program for Applicants with Disabilities: 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.

This position exists to lead quality management activities across the Program Integrity Oversight Division (PIO) by planning and coordinating quality assurance (QA), quality control (QC), and quality improvement (QI) functions. In leading quality management activities across the division, this position will be expected to lead the work of a Quality Management Specialist. Responsibilities include but are not limited to:

• Plan, coordinate, monitor, and evaluate regulatory and compliance requirement changes and assure divisional compliance with all state and federal laws related to PIO programs, functions, activities, investigations, and processes.
• Oversee the collection, gathering, and compilation of case management data.
• Coordinate the review and analysis of QA trends to detect compliance risks and the nexus for quality improvement that ensures conformance with state and federal laws, rules, regulations, and standards.
• Lead various meetings and engagements with internal and external staff, providers, and stakeholders.

Minimum Qualifications

• Three (3) years of experience formulating and defining scope, goals, and/or objectives for the design of quality management projects.
• Experience must demonstrate the following:
• Understanding of regulations, law and policy relating to Minnesota Health Care Programs and Medical Assistance.
• Identify areas of risk specific to program integrity and provide recommendations for resolution.
• Skilled in data analysis, interpretation and turning data into useful information to inform decision-making and/or continuous process improvements.
• Ability to prepare for and conduct audits, conduct surveys, and measure outcomes.
• Understanding of continuous improvement methodologies and tools.
• Report writing and presentation.

Preferred Qualifications

• Possess investigative techniques and problem resolution skills in order to manage the investigation and resolution of Medicaid provider cases.
• Experience establishing a Risk and Mitigation Plan.
• Understanding of the capabilities of automated computer systems and databases and be able to access, extract, manipulate and present data in different formats to support investigative activities.
• Lead quality/process/procedural change across multi-focus, multi-program, and/or multi-activity teams.
• Working knowledge of Microsoft Office suite, Visio, and the case management systems used by the investigative units.
• Effectively communicate with persons involved in investigations, minimizing conflict and de-escalating conflict should it arise.
• Variety of experiences working effectively with others from different backgrounds and cultures.

Additional Requirements

• This position requires successful completion of the following:
• Criminal background check
• Reference check
• Fingerprinting check (MNJIS/CJIS)
• Complete the Criminal Justice Information System (CJIS) Security Awareness training within 3-business days from the start of employment; and successfully obtain/retain CJIS certification annually.

AN EQUAL OPPORTUNITY EMPLOYER Minnesota State Colleges and Universities is an Equal Opportunity employer/educator committed to the principles of diversity. We prohibit discrimination against qualified individuals based on their race, sex, color, creed, religion, age, national origin, disability, protected veteran status, marital status, status with regard to public assistance, sexual orientation, gender identity, gender expression, or membership in a local commission as defined by law. As an affirmative action employer, we actively seek and encourage applications from women, minorities, persons with disabilities, and individuals with protected veteran status. Reasonable accommodations will be made 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. Please indicate what assistance is needed.