Medicaid Program Integrity Review Supervisor - Human Services Supervisor 2

Working Title: Medicaid Program Integrity Review Supervisor Job Class: Human Services Supervisor 2 Agency: Human Services Dept Location: St. Paul Telework Eligible: Yes Date Posted: 05/21/2026 Closing Date: 06/04/2026 Overview This 18‑month temporary position leads a team of temporary Medicaid Program Integrity Review Specialists. The team reviews behavioral health services billed to Medicaid to ensure claims are accurate and meet program requirements. Services reviewed include Adult Rehabilitative Mental Health Services (ARMHS), Intensive Residential Treatment Services (IRTS), Peer Services, and Assertive Community Treatment (ACT). As supervisor, you guide the team’s day‑to‑day work, answer questions about policy and clinical standards, ensure reviews are done consistently and on time, and serve as the main point of contact between the review team and DHS policy experts and Behavioral Health Administration (BHA) leadership. Key Responsibilities Supervise and support a team of temporary Program Integrity Review Specialists, helping them complete prepayment reviews, focused claims reviews, and provider recertification reviews accurately and on schedule. Provide guidance on clinical and policy questions — including medical necessity criteria, documentation standards, and program integrity requirements — so the team can make consistent, well‑grounded recommendations. Manage workload across the team, coordinating assignments and adjusting priorities as needed. Oversee onboarding and ongoing training so team members stay current on behavioral health services, review procedures, and DHS policy changes. Maintain accurate records of review activities and prepare regular reports on team outputs, trends, and outcomes for program leadership. Administer applicable labor agreements fairly and support team members in meeting performance expectations through coaching, feedback, and corrective action when needed. Serve as the primary liaison between the review team and DHS policy staff and BHA leadership. Minimum Qualifications Demonstrated leadership experience (e.g., supervisor, lead worker, team leader, project lead, completion of a State of Minnesota leadership program such as ELI or L4, paid/unpaid position leading a program or chairing a committee). Three (3) years of advanced‑level work experience conducting clinical and policy reviews of Medicaid services within a human services program, including a solid understanding of behavioral health conditions, treatment approaches, and service delivery for programs such as ARMHS, IRTS, Peer Services, and ACT; in‑depth knowledge of Medicaid program rules, medical necessity criteria, and clinical documentation standards for behavioral health services; hands‑on experience with program integrity review methods (prepayment review, focused claims review, provider recertification review); familiarity with audit processes, fraud prevention, and Medicaid program integrity standards; basic understanding of healthcare coding and billing as it applies to behavioral health services. Preferred Qualifications Variety of experiences working effectively with people from backgrounds and cultures different than one’s own. Strong communication skills — able to explain complex topics clearly, both in writing and in conversation, and to listen and respond openly to team members’ questions and concerns. Knowledge of supervisory practices, including workload management, coaching, performance feedback, and corrective action. Certification as a Program Integrity Professional (CPIP) or in Healthcare Compliance. Experience working with Medicaid claims platforms, electronic health record (EHR) systems, or reporting tools. Ability to identify patterns or trends in review findings that may signal systemic documentation issues or provider compliance concerns. Additional Requirements Background checks: The Minnesota Department of Human Services will conduct criminal background checks on all finalists for this position. Finalists must pass the DHS background check. Employee reference checks will be conducted on all finalists, including a review of documentation related to job performance and contact with former employers. Benefits Paid vacation and sick leave 12 paid holidays each year Low‑cost medical, dental, vision, and prescription drug plans, including fertility care, 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 Short‑term and long‑term disability insurance Tax‑free expense accounts for health, dental, and dependent care Resources that provide support and promote physical, emotional, social, and financial well‑being 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 encourage 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. Minnesota state agencies make reasonable accommodations to their employees and applicants with disabilities. 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