Medicare-Medicaid Integration Specialist

1 week ago


Richmond, Virginia, United States Commonwealth of Virginia Full time
Job Summary

The Department of Medical Assistance Services (DMAS) is seeking a highly skilled Medicare-Medicaid Integration Specialist to join our team. As a key member of our Integrated Care Division, you will play a critical role in providing exceptional delivery of services to our agency.

Key Responsibilities
  • Provide operational oversight of Medicare-Medicaid integration activities, ensuring compliance with guidelines and regulations.
  • Monitor, review, and analyze the activities of contracted managed care entities to ensure they are operating within prescribed guidelines.
  • Collaborate with Integrated Care Contract Monitoring, Data, Systems and Encounters and Policy Unit staff to create and implement operational oversight and monitoring plans.
  • Develop and provide reports to management, as well as provide technical expertise to stakeholders as needed.
  • Participate in meetings, conferences, and trainings, with occasional travel required.
Requirements
  • Experience with Medicaid and/or Medicare Managed Care programs, including contract management and compliance.
  • Knowledge of legislative practices, research, and evaluative techniques.
  • Ability to analyze issues and data, applying solutions to drive results.
  • Experience in contract management/oversight, with proficiency in Microsoft Office Suite.
  • Strong organizational skills, with ability to meet deadlines and communicate effectively with diverse stakeholders.
About the Department

The Department of Medical Assistance Services (DMAS) is committed to improving the health and well-being of Virginians through access to high-quality healthcare coverage. We value service, collaboration, trust, problem-solving, and adaptability, and we encourage talented individuals to join our team.

As a member of our team, you will have the opportunity to work in a dynamic and supportive environment, with a focus on delivering exceptional results. If you are a motivated and detail-oriented professional with a passion for healthcare, we encourage you to apply for this exciting opportunity.



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