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State of Minnesota Quality Assurance Examiner - Research Analysis Specialist Senior in St. Paul, Minnesota

Job Summary Job Summary This position analyzes and monitors regulatory compliance of Health Maintenance Organizations (HMO) and County-Based Purchasers (CBP) in accordance with federal and state rules and laws governing Minnesota Health Care Programs applicable to such managed care organizations. The incumbent must be able to examine in detail all facets of an HMO or CBP’s activities in the areas of quality assurance, utilization management, network adequacy and complaints and appeals. The incumbent works closely with representatives at the health plans before, during, and after the exam and also operates under limited supervision due to the high level of knowledge required as well as the substantial time spent in the field. This position collaborates with the Departments of Commerce and Human Services in their oversight roles for financial/actuarial review and public health programs respectively and participates in the annual review and approval of health plan filings leading up to open enrollment for both on and off exchange offerings. The person in this position also works on developing policy recommendations and their implementation to protect health care consumers in Minnesota. Qualifications Minimum Qualifications Three years of professional experience in healthcare, health insurance, public health, law, or related field. A valid Class D Drivers’ License. Experience must include the following to be considered a candidate: * Knowledge of health maintenance organizations, managed care organizations, or insurance. * Experience gathering information and data to perform qualitative and quantitative analysis. Preferred Qualifications * Bachelor’s degree in Health Services Research, Economics, Public Health, Nursing, Public Policy, Public Affairs, Statistics, Public Administration, Political Science, or related business. * An advanced degree in the fields above and/or legal background. * Licensed healthcare professional. * Experience writing and developing reports. * Project management and presentation skills. * Experience in quality assurance/quality improvement program in a managed care organization, clinic, or hospital. * Knowledge of regulatory and auditing principles. Additional Requirements This position requires successful completion of a background check. Application Details Why Work For Us Come work for one of the best public health systems in the nation and you will contribute to our mission to protect, maintain and improve the health of all Minnesotans. We are working hard to achieve our vision for health equity in Minnesota, where all communities are thriving and all people have what they need to be healthy. Our collaborative, mission-driven work environment is a major factor in promoting a high level of employee health awareness, employee longevity and job satisfaction. We offer a competitive benefits package including employee and family health and dental insurance, life insurance, disability insurance, health promotion programs, pre-tax benefits, vacation leave, sick leave, paid holidays, deferred compensation, retirement benefits, and more! How to Apply Click "Apply" at the bottom of the page. If you have questions about applying for jobs, contact the job information line at 651-259-3637. For additional information about the application process, go to http://www.mn.gov/careers. Contact If you have questions about the position, contact Lenny Thao atlenny.thao@state.mn.us or 651/201-4130. If you are a Connect 700 applicant, please email your certificate and the Job posting ID/number to Lenny Thao at Lenny.Thao@state.mn.us by the position close date. If you are an individual with a disability and need an accommodation for an interview, you may contact the Department of Health ADA Coordinator at health.hr.ada@state.mn.us * * * AN EQUAL OPPORTUNITY EMPLOYER 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 emailcareers@state.mn.us. Please indicate what assistance you need. Job Title: Quality Assurance Examiner - Research Analysis Specialist Senior Location: St. Paul Job ID: 46458 Regular/Temporary: Unlimited Full/Part Time: Full-Time Who May Apply: This vacancy is open for bids and for all qualified job seekers simultaneously. Bidders will be considered through 06/15/2021. Date Posted: 06/09/2021 Closing Date: 06/18/2021 Hiring Agency/Seniority Unit: The Minnesota Department of Health (MDH) Hiring Agency: The Minnesota Department of Health (MDH) Division/Unit: Health Policy / Managed Care Systems Work Shift: Day Shift / 8:00am - 4:30pm Work Hours: Day Shift / 8:00am - 4:30pm Work Shift/Work Hours: Day Shift / 8:00am - 4:30pm Days of Work: Monday - Friday Travel Required: Up to 25% Salary Range: $27.56 - $40.61/hourly; $57,545 - $84,793/annually Classified Status: Classified Bargaining Unit/Union: 214 - MN Association of Professional Employees (MAPE) Job Class: Research Analysis Specialist Senior Working Title: Quality Assurance Examiner