Healthcare Strategic Reimbursement Advisor

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:

This position reports to the Director of Rate Development and serves as the agency’s lead expert for researching, modeling, and recommending improvements to Medicaid provider payment methodologies.

The role encompasses comprehensive analysis of all existing rate-setting mechanisms and policies, including managed care, fee-for-service, supplemental payments, and cost settlements.

The incumbent will systematically benchmark Virginia’s provider reimbursement strategies against CMS requirements and practices across all states, then deliver concise, actionable recommendations to the Director of Rate Development.

All proposals must align with state and federal law, established agency policy, and current best practices.

Additionally, this position coordinates across divisions to assess and support the implementation of approved changes, including systems modifications, state plan amendments, regulatory updates, and budget submissions to the Department of Planning and Budget.

The incumbent is responsible for developing project plans and managing timelines for approved initiatives, ensuring timely implementation and resolution of issues, and providing expert interpretation of healthcare policy with a focus on 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.

Extensive 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:

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

Special Instructions

You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to “Your Application