**Bidders – Please note that you will be required to provide an updated resume to the hiring supervisor/manager for this position.**

This position reports to the TPA Medicare Enrollment Team within the Managed Care Contracting and Rates unit of DHS. This individual is responsible for evaluating and assigning the correct managed care product for consumers who are dually-eligible for Medical Assistance and Medicare. The individual will be familiar with eligibility requirements and policies as they relate to the Minnesota Senior Health Options (MSHO) or Special Needs BasicCare (SNBC) program(s). This position serves as a contact point for managed care organizations and county agencies with regard to enrollment questions, policies and practices. They will also be responsible for monitoring and insuring correct enrollment transactions to CMS and managed care organizations. This position is part of a section of managed care/Medicare implementation specialists and manages Prepaid Managed Health Care Programs (PMHCP). This position develops/modifies strategies and work plans to effectively use resources and implement conversion of fee-for service resources and ensure access for members. Main responsibilities: • Provide technical support and oversight to enrollment site operations and contracted health plans related to Minnesota Senior Health Options (MSHO), Special Needs Basic Care (SNBC) and Medicare Enrollment. • Reviews and analyzes data/information relating to MSHO, SNBC and Medicare enrollment and outcomes in order to monitor compliance, evaluate effectiveness and more effectively direct resources to address the health care needs of eligible members. • Process enrollments/dis-enrollments, monitor and account for and, if needed, correct transactions relating to MSHO, SNBC and Medicare enrollments and payment. Within specified time lines, ensure that adjustments are made accurately in a timely manner and in accordance with contract and/or Federal requirements.

Two years professional experience working with Health Care Programs and Managed Care Policy demonstrating the following: • Working knowledge of medical program eligibility, benefits, managed care policy and payment process. • Ability to analyze data, trends, prepares statistical reports, conduct large meetings and present information. *Bachelor's degree or higher degree in human services, business, healthcare or related field may substitute one year of professional experience.