Medicare- Medicaid Integration Specialist

Richmond, Virginia


Employer: Virginia Jobs
Industry: Dept of Med Assistance Svcs
Salary: $74408 - $75854 per year
Job type: Full-Time

Title: Medicare- Medicaid Integration Specialist

State Role Title: Prog Admin Specialist II

Hiring Range: $74,408 - $75,854

Pay Band: 5

Agency: Dept of Med Assistance Svcs

Location:Dept of Medical Asst Services

Agency Website:www.dmas.virginia.gov

Recruitment Type: General Public - G

Job Duties

The Department of Medical Assistance Services (DMAS) is excited to offer a competitive opportunity to serve as a Medicare- Medicaid Integration Specialist. The selected competitive candidate will provide exceptional delivery of services to the agency's Integrated Care Division.

Job responsibilities will include, but are not limited to:

The chief objective of this position is to provide operational oversight of Medicare-Medicaid integration activities of programs that enroll our dual eligible (enrolled in both Medicare and Medicaid) population.

This will include, but is not limited to, monitoring, reviewing and analyze the activities of our contracted managed care entities to ensure they are operating within the guidelines prescribed by the Department.

This position will work closely with Integrated Care Contract Monitoring, Data, Systems and Encounters and Policy Unit staff, as well as staff across the Department, to create and implement operational oversight and monitoring plans.

This position is responsible for providing reports to management and providing technical expertise to stakeholders when needed.

This position may require limited travel (intra- and inter-state) for meetings, conferences, and/or trainings.

Located in beautiful Central Virginia, the Richmond area puts you just 2 hours from the Blue Ridge Mountains, Virginia Beach and Washington DC. To learn more about the Richmond, VA area visit: https://www.virginia.org

The Department of Medical Assistance Services (DMAS) is working to improve the health and well-being of Virginians through access to high quality health care coverage.

DMAS wants talented individuals who can align their experience with the mission of the agency and its core values - service, collaboration, trust, problem solving and adaptability.

At the Department of Medical Assistance Services (DMAS) we encourage and promote that you Come as you are | Become who you want to be | That is our promise.

Minimum Qualifications

Competitive candidates will meet these minimum qualifications:

Experience with Medicaid and/or Medicare Managed Care programs to include contract management and compliance of contracts.

Knowledge of legislative practices, research, and evaluative techniques.

Experience analyzing issues and data and applying solutions.

Experience in contract management/oversight.

Experience with Microsoft Office Suite.

Experience analyzing, interpreting, and applying state and/or federal regulations and laws.

Experience demonstrating organizational skills and meeting deadlines.

Experience communicating and collaborating with diverse internal and external stakeholders.

Additional Considerations

There are no additional considerations at this time.

Special Instructions

You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to "Your Application" in your account to check the status of your application for this position.

The Virginia Department of Medical Assistance Services (DMAS) does not offer employment-based Sponsorship. Selected candidates will have their work authorization completed using the E-Verify Program.

The Department of Medical Assistance Services (DMAS) is an Executive Branch agency that will adhere to all policies and procedures, to include the Commonwealth's Department of Human Resource Management Policy 1.61 Teleworking.

This position requires a fingerprint based Criminal History Background Check, Education Checks if applicable, Work History Verification with references.

If you wish to apply for a job with the Department of Medical Assistance Services, an application and/or resume for employment must be submitted electronically through this website. Mailed, faxed, emailed, or hand-delivered applications/resumes will not be accepted. Consideration for an interview is based solely on the relevant information presented in the state application and/or resume submitted before the closing date.

Applications and/or resumes should include relevant work history which indicates your qualifications for this position.

The Department of Medical Assistance Services practices fair and equal employment opportunity to all employees and applicants in accordance with applicable laws and regulations. It is our policy to prohibit discrimination on the basis of race, sex, color, national origin, religion, sexual orientation, gender identity, age, veteran status, political affiliation, genetics, or disability in the recruitment, selection, and hiring of its workforce.

In support of the Commonwealth's commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth's Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly called a Certificate of Disability) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans may also apply via the AHP if they also provide an AHP Letter. To request an AHP Letter, use this link: https://www.dars.virginia.gov/drs/cpid/PWContact.aspx or call DARS at 800-552-5019, or DBVI at 800-622-2155

The Department of Medical Assistance Services is a V3 certified state agency that provides hiring preference to veterans and members of the reserves and/or National Guard in support of executive order 29, (2010). If you are a Veteran or Spouse of a Veteran or Active Military Member, DMAS encourages you to apply and respond accordingly on your state application.

Contact Information

Name: DMAS Talent Acquisition

Phone: (804)-225-4407

Email: askhcdtalentacq@dmas.virginia.gov

In support of the Commonwealth's commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly COD) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their AHP Letter. Requesting an AHP Letter can be found at AHP Letter or by calling DARS at 800-552-5019.

Note: Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1, 2022- February 29, 2024, can still use that COD as applicable documentation for the Alternative Hiring Process.

Created: 2024-06-09
Reference: 5017932_Ht7jSxtH1FDf
Country: United States
State: Virginia
City: Richmond
ZIP: 23222


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