Senior Systems Analyst for Encounters

Title: Senior Systems Analyst for Encounters

State Role Title: Info Technology Specialist III

Hiring Range: $108,879 - $112,800

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 Senior Systems Analyst for Encounters in the Integrated Care Division.

Job responsibilities will include, but are not limited to:

Integrated Care Division (IC) subject matter expert for encounters.

Serve as the primary representative for the creation of the data analytics solution to measure encounter completeness.

Oversee, coordinate, and monitor all Cardinal Care Managed Care (CCMC) encounter submissions for CCMC contractors. Ensure compliance of encounter submissions with all CCMC contractual requirements and with all current EDI and HIPAA standards.

Develop and maintain innovative and effective procedures to assess vendor submission compliance and encounter data quality.

The business needs for this position may be completed virtually.

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 technical and industry knowledge of current healthcare Electronic Data Interchange (EDI) processing standards.

Considerable knowledge of encounter processing.

Considerable knowledge of National Council for Prescription Drug Programs (NCPDP).

Considerable knowledge of the principles and practices of healthcare claims payments.

Considerable knowledge of a managed care delivery system.

Considerable knowledge ensuring compliance with necessary rules, regulations, standards and laws.

Experience in meeting deadlines.

Experience with internal/external stakeholders.

Extensive knowledge of Electronic Data Interchange (EDI) standards.

Extensive knowledge of the Health Insurance Portability and Accountability Act (HIPAA), X12 837 transaction sets.

Extensive knowledge of data extraction and analysis.

Additional Considerations

Competitive candidates should meet these additional considerations:

Considerable technical (SAS, SQL, etc.) skills.

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 b