Member and Provider Relations Specialist - Richmond, United States - Dept of Med Assistance Svcs

Dept of Med Assistance Svcs

Verified Company

Richmond, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Title:
Member and Provider Relations Specialist

State Role Title:
Prog Admin Specialist II

Hiring Range:
$72,240 - $90,543

Pay Band: 5

Agency:
Dept of Med Assistance Svcs

Location:
Dept of Medical Asst Services

Recruitment Type:
General Public - G

Job Duties
Job responsibilities will include, but are not limited to:

The chief objective of this position is to monitor and track all Cardinal Care Managed Care program activity to ensure that providers and Cardinal Care Managed Care organizations are operating within contract guidelines.

Research and investigate issues relating to member access to care, health care issues and member benefits.

Provide the technical expertise to enrollees, providers, health plans, and the Integrated Care Division in areas of enrollment, and covered benefits.

Coordinate, in conjunction with health plans, outreach efforts to enrollees, providers, and other stakeholders related to the Cardinal Care Managed Care program.

Effective and efficient expertise in decisions regarding distribution of information provided to enrollees, providers and stakeholders.

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

Knowledge of the administration of managed care programs to include eligibility, regulations, covered services and benefits, and general contractual requirements.

Working knowledge of the Medicaid Management Information System (MMIS).

Working knowledge of managed care contracts.

Considerable experience providing training, using a variety of modalities, to diverse groups, including enrollees, advocates, providers, stakeholders, and health plan staff.

Considerable knowledge of utilizing computer software programs.

Experience in meeting deadlines.

Experience with internal/external stakeholders.

Additional Considerations
There are no additional considerations for this position.

Special Instructions

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.

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.

Contact Information

Name:
DMAS Talent Acquisition

Phone:

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.

Each agency within the Commonwealth of Virginia is dedicated to recruiting, supporting, and maintaining a competent and diverse work force.

**Equal Opportunity Employer