Medicare - Medicaid Integration Specialist

Medicare - Medicaid Integration Specialist

The Department of Medical Assistance Services (DMAS) is excited to offer a competitive opportunity to serve as the Medicare-Medicaid Integration Specialist. The selected competitive candidate will provide exceptional delivery of services to the Integrated Care Division. Job responsibilities 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 analyzing the activities of our contracted managed care entities to ensure they operate 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 training. The business needs for this position may be completed virtually. 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 : 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.

Competitive candidates will meet these minimum qualifications : Experience with Medicaid and / or Medicare Managed Care programs to include contract management / oversight 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.

There are no additional considerations for this position.

You will be provided a confirmation of receipt when your application and / or rsum 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 could be expected to work in the office as driven by business needs. 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 : AHP Letter or call DARS at 800-552-5019.

Contact Information :

Name : DMAS Talent Acquisition

Phone : (804) 225-4407

Email : askhcdtalentacq@dmas.virginia.gov

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.