Eligibility Projects Specialist

Title: Eligibility Projects Specialist

State Role Title: Prog Admin Specialist I

Hiring Range: $25.00 - $27.00

Pay Band: UG

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 Eligibility Projects Specialist. The selected competitive candidate will provide exceptional delivery of services to the agency’s Eligibility and Enrollment Division.

Job responsibilities will include, but are not limited to:

This position will serve as Eligibility Projects Specialist and serve as a technical eligibility liaison.

This position requires the ability to work collaboratively across the agency with outside stakeholders and conduct comprehensive project management.

This position will be responsible for performing detailed, highly technical analysis of Medicaid eligibility and enrollment issues in Virginia Case Management System (VaCMS) and Medicaid Management Information System (MMIS)/ Fiscal Agent Services (FAS), and for the summarization of the data for internal and external reporting.

Data compiled will be used in substantiating claims to the Centers for Medicare and Medicaid (CMS).

Based on the outcome of the analysis, this position will also be responsible for the development and implementation of eligibility policy and
regulations and for providing professional consultation and assistance to statewide programs for targeted populations.

This position will plan, schedule, and complete the analysis and evaluation of eligibility determinations for cases selected by CMS for review.

This position will represent the Eligibility and Enrollment Services Division in other various enrollment audits and reviews.

This position will also provide eligibility expertise to the Division and across the Agency.

As an employee of DMAS you are entitled to the many comprehensive benefits the Commonwealth has to offer. This includes health benefits, 12 paid holidays, paid leave, flexible work schedules, & retirement plans. For more specific details please visit: https://www.dhrm.virginia.gov/employeebenefits

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 knowledge of state and federal health care program requirements with an emphasis on Medicaid and the Family Access to Medical Insurance Security (FAMIS) programs.

Considerable knowledge and experience of automated systems involving eligibility determination and enrollment, to include the Virginia Case Management System (VaCMS) and the Medicaid Management Information System (MMIS), the Medicaid Enterprise System (MES) or any successor system.

Considerable experience with Medicaid/FAMIS eligibility policy and system enrollment processes.

Demonstrated experience conducting research, analyzing data, problem solving and identifying solutions and appropriate actions.

Considerable experience operating a personal computer with spreadsheets, word processing and presentation software to include Excel, Word, and PowerPoint.

Considerable experience analyzing, interpreting, and applying federal, state laws/regulations.

Experience meeting deadlines.

Experience communication with internal and external stakeholders.

Additional Considerations

There are no additional considerations for this position.

Special Instructions

You will be provided a confirmation of receipt when your appl