Direct Medicaid program integrity reviews in St. Paul while supervising policy analysts and applying clinical review, analytics, and compliance expertise.

The Human Services Dept seeks a Human Services Supervisor 2 for BHA’s behavioral health Medicaid payment integrity program. This full time, day-shift position leads review strategy across substance use disorder, mental health, and integrated services. Telework may be available with approval for eligible Minnesota or bordering-state residents.

Key Responsibilities:

- Direct prepayment and CMS-focused claims reviews across behavioral health services
- Supervise five Medicaid Payment Integrity Policy Analysts
- Set program goals, standards, targeting, and review strategy
- Lead review expansion across BHA Medicaid-funded services




- Coordinate quality assurance and performance measurement with data analytics

Requirements:

- Demonstrated leadership experience identifying issues, goals, and strategic actions
- Knowledge of Minnesota behavioral health delivery and documentation standards
- Experience with Medicaid integrity, claims review, and risk targeting
- Knowledge of coverage, medical necessity, coding, billing, and claims processing
- Bachelor’s or master’s degree may substitute for qualifying experience

Lead behavioral health Medicaid oversight through supervision, claims review, policy interpretation, and data-informed program integrity decisions.

📌 Medicaid Program Integrity Supervisor (St Paul)
🏢 Minnesota Direct Care and Treatment
📍 St Paul