Title: Healthcare Strategic Reimbursement Advisor

State Role Title: Prog Admin Manager III

Hiring Range: $103,342 - $139,190

Pay Band: 6

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 the Healthcare Strategic Reimbursement Advisor in the Provider Rate Development Division.

Job responsibilities will include, but are not limited to:

Incumbent will provide operational support to the Assistant Director and Director of Provider Rate Development. This position will assist with the coordination of a variety of projects, ensure that legislative and project deadlines are met and operational issues are elevated and resolved when necessary. Ensure all processes and procedures within division are properly documented and all contracts within scope of the division are properly executed and managed.

The position provides management and leadership for supplemental payments as well as cost settlements and auditing of provider cost reports. This position reports directly to the Director of Rate Development and provides assistance with management and strategic planning for all rate setting and provider payment methodology programs for the Department of Medical Assistance Services, in accordance with state and federal laws and established policies and procedures. This position provides assistance with policy development, interpretation and implementation related to health care policy and, specifically, in the area of Medicaid payment methodologies. The business needs for this position have in office requirements to include but are not limited to attending in-person division meetings and attending internal and external stakeholder’s meetings.

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:

Considerable experience in leading complex projects, as a subject matter expert, from inception to completion for Provider Reimbursement.

Considerable work-related experience in finance and analyzing data to draw conclusions and recommendations.

Considerable experience applying statistical and quantitative methods.

Considerable experience in developing processes and procedures for complex financial analysis.

Considerable experience with calculating fiscal impacts of policy changes.

Considerable experience in policy development.

Considerable experience as a power user of Excel, including extensive use of advanced formulas and aggregating data using pivot tables.

Considerable knowledge of state and federal regulatory processes and experience applying regulations and policy to financial model development.

Considerable experience in meeting deadlines.

Considerable experience communicating with internal and external stakeholders.

Considerable work-related supervisory experience.

Additional Considerations

Competitive candidates should meet these additional considerations:

Experience with Medicaid rate setting for managed care and/or fee-for-service programs, supplemental payments, cost settlements, or capitation rate setting.

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 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.

This position requires the submission of a Statement of Economic Interest (financial disclosure).

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.