Health Plan Program Analyst - Richmond, United States - Virginia Department of Human Resource Management
Description
Health Plan Program AnalystJob no:
5014276
Work type:
Full-Time (Salaried)
Location:
Richmond (City), Virginia
Categories:
Health and Human Services
Title:
Health Plan Program Analyst
State Role
Title:
Prog Admin Specialist II
Hiring Range:
$72,240 - $82,309
Pay Band:
5
Agency:
Dept of Med Assistance Svcs
Location:
Dept of Medical Asst Services
Agency Website:
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 Health Plan Program Analyst.
Job responsibilities will include, but are not limited to:
The chief objective of this position is to monitor, review, and analyze program activities of contracted Managed Care Organizations (MCOs).
The incumbent of this position ensures MCOs are operating within contractual guidelines by aiding in development of an annual Contact Monitoring Plan, analyzing reports and data submitted by the MCOs for trends and areas of concern, conducting reviews of entries made by MCOs into DMAS portal software, and submitting compliance referrals to the compliance team and reports to management as necessary.
For more specific details please visit:
Located in beautiful Central Virginia, the Richmond area puts you just 2 hours from the Blue Ridge Mountains, Virginia Beach and Washington DC.
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:
Knowledge of Managed Care programs to include contract management and compliance with contracts.
Knowledge of Integrated Care practices.
Knowledge of State/Federal Medicaid Appeals and Grievances requirements.
Experience in research, analysis, and evaluative techniques.
Experience applying and/or interpreting State/Federal Medicaid and/or Medicare policies and procedures.
Experience utilizing healthcare and management software applications.
Experience demonstrating organizational skills and meeting deadlines.
Experience communicating and collaborating with diverse internal and external stakeholders.
Additional Considerations
Competitive candidates should meet these preferred qualifications:
Considerable experience in the Medical Enterprise System (MES) software application.
Special Instructions
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.
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.
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:
or call DARS at , or DBVI at
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, 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.
Name:
DMAS Talent Acquisition Team
Phone:
Email:
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 atNote :
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.
18 Apr 2024 Eastern Daylight Time
Applications close:
02 May 2024 Eastern Daylight Time
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