MN Health Insurance Program Representative 2

Minnesota Department of Human Services
November 1, 2019
St. Paul, MN
Job Type


Job Class: Minnesota Health Program Representative 2

Working Title: Lead Worker

Who May Apply: Open to all qualified job seekers

Date Posted: 10/31/2019

Closing Date: 11/06/2019

Hiring Agency/Seniority Unit: Department of Human Services / Central Office

Division/Unit: Health Care Administration / Medicaid Payments & Provider Services, PR PCC Pharmacy

Work Shift: Day Shift

Work Hours: 8:00 a.m. to 4:30 p.m.

Days of Work: Monday - Friday

Travel Required: No

Salary Range: $20.30 - $28.54/hourly; $42,386 - $59,591/annually

Classified Status: Classified

Bargaining Unit/Union: 207 - Technical/AFSCME

Work Area: G

FLSA Status: Nonexempt
Connect 700 Program Eligible : Yes

Job Summary

Job Summary
***This posting will be used to fill up to 2 identical openings .
The purpose of this position is to support enrollment and eligibility determinations for Minnesota Health Care Programs (MHCP) providers and consumers. Determinations of eligibility are made by applying a myriad of interrelated and complex policies and guidelines that are unique to each program, applicant and enrollee and the eligibility and enrollment will be conducted in an online web portal. The incumbent, working in a high volume and data/deadline driven environment with extensive provider contact, must be able to research, analyze and discern the appropriate and relevant assistance level that may be required across a variety of public and private options for each provider including the ability to direct problem solve or triage callers into the correct assistance service. The decisions made by the incumbent impact whether or not an applicant becomes an enrolled MHCP provider or may impact the applicants' right to appeal or actively seek eligibility, payment for covered services and coverage policy from Minnesota Health Care Programs (MHCP). The misapplication of policy and errors in eligibility and payment coverage determination impacts health care provider access for the affected parties as well as the integrity of the program(s). This position will operate in a Tiered design call center with this position providing specialty level assistance in a rapid responder type of environment in which staff needs more in depth consultation for the types of calls they receive.
Responsibilities include:

  • In a high volume, customer service oriented, inbound call center work environment, answering incoming phone calls and serve as a specialized subject matter expert for the representatives of the Provider Call Center and/or callers accessing the DHS Provider Call Center and other DHS internal or external stakeholders
  • Service as secondary level contact for Provider Call Center representatives who provide direct assistance to callers along with handling calls to the Minnesota Health Care Programs Provider call center and serve as a specialized subject matter expert
  • Serve as a mentor for newly hired Provider Call Center representatives
  • Maintain flexibility and versed on the rate of provider and their specialized needs as well as have a broad understanding of MHCP programs, county operations, provider and recipient needs in order to provide coverage for any station/work area of the Provider call center
  • Assist with the management of heavy call volume and activity in response to major problems, changes or workload


Minimum Qualifications
One (1) year professional experience; OR
Two (2) years advanced technical/advanced paraprofessional experience
Experience must demonstrate the following:

  • Experience providing customer service in a call center or operations related environment with experience in policy and the federal and state laws and regulations governing DHS and/or Minnesota Health Care programs and policies, clientele, application processes, eligibility criteria and enrollment operations.
  • Experience with administrative, organizational, and analysis skills, including time and priority management, sufficient to work on several projects simultaneously in a fast paced environment within deadlines.
  • Experience with effective professional communication skills that contribute to a positive and productive work environment, through attentive and respectful written, verbal and non-verbal interactions.

Preferred Qualifications
• Experience in Health Care with an emphasis on Minnesota Health Care Programs.
• Experience working effectively within a high volume, deadline-orientated, and accuracy-focused program.
• Experience working with extreme attention to detail and accuracy.
• Experience working within the new eligibility system as it relates to the Minnesota Health Care programs.
• Experience using state mainframe systems such as MAXIS, MMIS, and METS.
• Knowledge of Affordable Care Act.
• Ability to administer policies, procedures, and systems to discuss eligibility concerns or enrollment issues.
• Ability to multi-task and work independently with a strong work ethic and demonstrated record of regular attendance.
• Ability to interact and communicate with a diverse group of individuals.
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.


The State of Minnesota is an equal opportunity, affirmative action, and veteran-friendly employer. We are committed to providing culturally responsive services to all Minnesotans. 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 . Please indicate what assistance you need.

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