Eligibility Projects Specialist
2 months ago
Job Summary
The Commonwealth of Virginia is seeking a highly skilled Eligibility Projects Specialist to join our team. As a key member of our Department of Medical Assistance Services, you will play a critical role in ensuring the accuracy and efficiency of Medicaid eligibility determinations.
Key Responsibilities
- Provide technical expertise in Medicaid eligibility and enrollment processes, including analysis and interpretation of federal and state laws, rules, regulations, and guidelines.
- Conduct comprehensive project management, including planning, scheduling, and completing analysis and evaluation of eligibility determinations for cases selected by CMS for review.
- Develop and implement eligibility policy and regulations, and provide professional consultation and assistance to statewide programs for targeted populations.
- Represent the Eligibility and Enrollment Services Division in various enrollment audits and reviews.
- Provide eligibility expertise to the Division and across the Agency.
Requirements
- Considerable knowledge of the Virginia Case Management System (VaCMS) and Medicaid Management Information System (MMIS), or any successor systems.
- Considerable experience providing sound technical and programmatic assistance to individuals inquiring about the Medicaid and FAMIS programs.
- Considerable experience in the eligibility and enrollment process with experience determining eligibility for the Medicaid and CHIP programs.
- Experience conducting research or studies.
- Considerable policy knowledge of publicly administered assistance programs, such as Medicaid (to include Families and Children, Aged, Blind, and Disabled (ABD), Long-Term Supports and Services (LTSS).
- Considerable policy knowledge of Children's Health Insurance Program (CHIP)/Family Access to Medical Insurance Security (FAMIS).
- Considerable experience operating a personal computer with spreadsheets, word processing and presentation software to include Excel, Word, and PowerPoint.
- Knowledge and experience analyzing, interpreting, and applying federal and state laws, rules, regulations, and guidelines.
- Experience meeting deadlines.
- Experience with internal/external stakeholders.
Preferred Qualifications
- Experience working in a healthcare or social services environment.
- Knowledge of healthcare policy and regulations.
- Experience with project management software and tools.
What We Offer
- A competitive salary and benefits package.
- The opportunity to work in a dynamic and fast-paced environment.
- The chance to make a meaningful contribution to the health and well-being of Virginians.
How to Apply
To be considered for this opportunity, please submit your application and/or resume through our website. We are an equal opportunity employer and welcome applications from diverse candidates.
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