Job Information
State of Minnesota Medical Policy Specialist/Compliance Services Officer Senior in St. Paul, Minnesota
Working Title: Medical Policy Specialist
Job Class: Compliance Services Officer Senior
Agency: Labor & Industry Dept
Job ID : 83610
Location : St. Paul
Telework Eligible : Yes
Full/Part Time : Full-Time
Regular/Temporary : Unlimited
Who May Apply : Open to all qualified job seekers
Date Posted : 02/04/2025
Closing Date : 02/10/2025
Hiring Agency/Seniority Unit : Labor & Industry Dept / Labor and Industry-MAPE
Division/Unit : Dept of Labor & Industry / Compliance #1
Work Shift/Work Hours : 8:00 am - 4:30 pm
Days of Work : Monday - Friday
Travel Required : No
Salary Range: $31.92 - $47.05 / hourly; $66,648 - $98,240 / annually
Job Class Option : Medical Policy Analyst
Classified Status : Classified
Bargaining Unit/Union : 214 - MN Assoc of Professional Empl/MAPE
FLSA Status : Nonexempt
Designated in Connect 700 Program for Applicants with Disabilities (https://mn.gov/mmb/careers/diverse-workforce/people-with-disabilities/connect700/) : Yes
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.
What's great about this job:
This position offers a hybrid work schedule which includes telework days and in office days at the St. Paul office.
The purpose of this position is to assess, implement and enforce Department policy and programs to ensure that effective medical services are provided to Minnesota injured workers. The incumbent of this position will:
1) Analyze and assess national and state medical policies, programs and market trends to recommend policy, rule and legislation.
2) Provide training and consultation to stakeholders concerning workers’ compensation medical issues.
3) Investigate complaints and administer appropriate discipline on medical issues, including professional conduct complaints.
4) Certify and monitor workers’ compensation certified managed care plans.
5) Maintain effective working relationships with entities that may impact Minnesota workers’ compensation medical benefits, procedures or policies.
6) Perform other work as assigned.
Minimum Qualifications
· Three years’ experience providing claim management, health care services and/or medical policy services in the field of workers’ compensation.
· Knowledge and understanding of medical services, supplies, treatment methodologies, terminology, professional ethics, and scope of practice.
· Knowledge and understanding of occupational, personal and mental injuries impacting injured workers.
· Knowledge and understanding of Minnesota workers' compensation statutes, rules, case law, and state and federal laws concerning health care privacy (e.g., HIPAA).
· Knowledge and understanding of health care billing and payment systems.
· Research and analytical skills sufficient to understand, apply and train on regulations and case law interpreting medical policy.
· Conflict resolution skills sufficient to negotiate disputed issues.
· Interpersonal skills sufficient to resolve conflict, negotiate disputed issues and develop and maintain effective-positive work relationships.
· Ability to communicate effectively with individuals with a wide range of backgrounds, who do not share your same culture, ethnicity, language, or other common experiences.
Preferred Qualifications
Experience with training and public speaking.
Experience with boards subject to the Open Meeting Law.
Experience with regulatory compliance.
Experience presenting complex ideas and materials to an audience unfamiliar with the underlying subject matter.
Language skills other than English (such as Somali, Spanish, Hmong, Karen or ASL).
Knowledge of workers' compensation certified managed care plans.
Experience with rulemaking pursuant to the Minnesota Administrative Procedure Act.
Additional Requirements
It is the policy that all final candidates submit to a background investigation prior to employment. The background check may consist of the following components: SEMA4 Records Check, Employment Reference Check, Driver’s License Check, Education/License Verification.
This position is designated for hybrid:
Hybrid for State of MN allows an employee to work a portion of the time remotely with a regular schedule of time at the designated office.
Only candidates located in Minnesota and bordering states (Iowa, North Dakota, South Dakota, or Wisconsin) are eligible.
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.
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