Appeals Representative - Human Services Program Representative 1

Job Details

Working Title: Appeals Representative
Job Class: Human Services Program Representative 1
Agency: Human Services Dept

• Job ID: 85671
• Location: St. Paul
• Telework Eligible: Yes
• Full/Part Time: Full-Time
• Regular/Temporary: Limited
• Who May Apply: Open to all qualified job seekers
• Date Posted: 04/17/2025
• Closing Date: 04/28/2025
• Hiring Agency/Seniority Unit: Human Services Dept / MAPE DHS Central Office
• Division/Unit: Health Care Administration/ Integrity and Accountability
• Work Shift/Work Hours: Day Shift / 8:00am - 4:30pm
• Days of Work: Monday - Friday
• Travel Required: No
• Salary Range: $28.82 - $42.31 / hourly; $60,176 - $88,343 / annually
• Classified Status: Unclassified
• Bargaining Unit/Union: 214 - MN Assoc of Professional Empl/MAPE
• End Date: Approximately 06/30/2026
• FLSA Status: Nonexempt
• Designated in Connect 700 Program for Applicants with Disabilities: No

The Department of Human Services is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DHS does not participate in E-Verify.

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.

Job Summary

This position is temporary and includes full state fringe benefits; the position is expected to last up to one year.

This position exists to represent the Department of Human Services in recipient eligibility appeals for certain Minnesota Health Care Programs (MHCP) administered through the Minnesota Eligibility Technology System (METS).

As a respondent for MHCP recipient eligibility appeals, the incumbent functions as an expert-level case worker tasked with researching and analyzing each appeal case to discern whether agency actions followed established program guidelines. This position makes case updates and corrections as needed to arrive at appropriate program eligibility for recipients and defends the agency’s legal position on appeal where necessary. The incumbent will use their knowledge of MHCPs, METS, and other supporting resources to perform daily tasks.

Responsibilities include:

• Research and respond to decisions and determinations that have been formally appealed or referred to an administrative hearing officer. Consequently, correct case errors and contact the appellant to discuss resolution when applicable, draft persuasive policy positions explaining the agency’s determination and applying law and agency policy to individual cases. Follow up on the implementation of the resolution or decision and draft and/or respond to requests for reconsideration and/or appeals.
• Determine eligibility for certain Minnesota health care programs.
• Collaborate with staff from DHS, MNsure, and other state agencies and divisions to research, analyze and respond to agency eligibility appeals.
• Maintain expert knowledge of changes and updates to policies, procedures, practices, forms, available resources, and systems used in relationship to his/her job functions.

Qualifications

Minimum Qualifications

• Experience with eligibility systems such as the Minnesota Eligibility Technology System (METS) and Minnesota Medicaid Information System (MMIS);
• Research and analytical experience and the ability to apply those skills in problem resolution.

Preferred Qualifications

• Advanced knowledge and at least two years’ experience administering multiple Minnesota Health Care Programs, including Medical Assistance and MinnesotaCare within the Minnesota Eligibility Technology System (METS).
• Ability to explain complex policies and program constraints effectively, both orally and in writing.
• Demonstrated organizational and time management skills.
• Proficiency with Microsoft Office products (Word, Excel, Outlook) and the ability to navigate multiple software applications.
• Knowledge of state and federal regulations governing Minnesota Health Care Programs, including: processes, procedures, appeals, regulations, and determining eligibility for MinnesotaCare and/or Medical Assistance.
• Demonstrated ability to multi-task and quickly switch focus.
• Variety of experiences working effectively with others from different backgrounds and cultures.

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.

Application Details

How to Apply

Select “Apply for Job” at the top of this page. If you have questions about applying for jobs, contact the Careers Help Desk at 651-259-3637 or email careers@state.mn.us. For additional information about the application process, go to http://www.mn.gov/careers.

Contact

If you have questions about this position, contact Teressa at Teressa.saybe@state.mn.us

To receive consideration as a Connect 700 Program applicant, apply online, email the Job ID#, the Working Title and your valid Proof of Eligibility Certificate by the closing date to Kelly Ellich at kelly.ellich@state.mn.us.

If you are an individual with a disability and need an ADA accommodation for an interview, you may contact the Department of Human Services’ ADA Coordinator at 651-431-4945 or DHS_ADA@state.mn.us for assistance.

About Human Services Dept

WE MAKE A DIFFERENCE! The Minnesota 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.

What do Minnesota's State employees have in common?

• A sense of purpose in their work
• Connection with their coworkers and communities
• Opportunities for personal and professional growth

Benefits

As an employee, you'll have access to one of the most affordable health insurance plans in Minnesota, along with other benefits to help you and your family be well.

Your benefits may include:

• Paid vacation and sick leave
• 12 paid holidays each year
• Low-cost medical, dental, vision, and prescription drug plans
  • Fertility care, including IVF
  • Diabetes care
  • 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
• Resources that provide support and promote physical, emotional, social, and financial well-being

Support to help you reach your career goals:

• Training, classes, and professional development
• Tuition reimbursement
• Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at studentaid.gov)

Employee Assistance Program (EAP) for work/life support:

• A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance
• Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
• Daily Living/Convenience Services: Chore services, home repair, trip planning, child/elder care

Programs, resources and benefits eligibility varies based on type of employment, agency, funding availability, union/collective bargaining agreement, location, and length of service with the State of Minnesota.

EQUAL OPPORTUNITY EMPLOYERS

Minnesota state agencies are equal opportunity, affirmative action, and veteran-friendly employers. State agencies are committed to creating a workforce that reflects the diversity of the state and strongly encourages persons of color and Indigenous communities, members of the LGBTQIA2S community, individuals with disabilities, women, and veterans to apply. The varied experiences and perspectives of employees strengthen the work we do together and our ability to best serve Minnesotans.

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, sex (including pregnancy, childbirth, and disabilities related to pregnancy or childbirth), gender identity, gender expression, marital status, familial status, age, sexual orientation, status regarding public assistance, disability, veteran status or activity in a local Human Rights Commission or any other characteristic protected by law.

APPLICANTS WITH DISABILITIES

Minnesota state agencies make reasonable accommodations to their employees and applicants with disabilities. If you have a disability and need assistance in searching or applying for jobs with the State of Minnesota, call the Careers Help Desk at 651-259-3637 or email careers@state.mn.us and let us know the support you need.