Appeals Representative - Human Services Program Representative 1

About the role

The 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.

Responsibilities

• Research and analyze recipient eligibility appeals to determine whether agency actions complied with applicable laws, regulations, policies, and program requirements, resolving issues when appropriate.
• Prepare and present the agency's position by drafting persuasive appeal summaries, responding to additional requests, and representing the agency during administrative appeal hearings.
• Determine eligibility for Minnesota Health Care Programs, collaborate with internal and external partners to resolve complex cases, and maintain expertise in evolving policies, procedures, and eligibility systems.

Requirements

• Two years professional experience determining eligibility for Medical Assistance or MinnesotaCare using automated eligibility systems and demonstrating:
  • Experience using eligibility systems such as the Minnesota Eligibility Technology System (METS) and Minnesota Medicaid Information System (MMIS).
  • Strong analytical, research, and problem-solving skills, including the ability to interpret and apply complex policies and regulations.
  • Experience preparing clear, accurate written documentation and communicating complex information effectively.
• Current working knowledge of the eligibility rules and policy requirements of Minnesota Health Care Programs, including MinnesotaCare and family-based Medical Assistance within the Minnesota Eligibility Technology System (METS).
• Experience representing an agency in administrative appeals, hearings, or other formal review proceedings.
• Proficiency with Microsoft Office products (Word, Excel, Outlook) and the ability to navigate multiple software applications.
• Variety of experiences working effectively with others from different backgrounds and cultures.

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 and year for each job held.

Skills

• Advanced knowledge of MHCP eligibility policy, METS, and related systems.
• Strong analytical, research, and written communication skills.

Benefits

• Paid vacation and sick leave.
• 12 paid holidays each year.
• Low-cost medical, dental, vision, and prescription drug plans.
• Fertility care, including IVF.
• 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.

Pay

$29.76 - $43.69 / hourly; $62,138 - $91,224 / annually

Schedule

Day Shift / 8:00am - 4:30pm