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 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 requires a fingerprint based Criminal History Background Check, Education Checks if applicable, Work History Verification with references.

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 be accepted. Consideration for an interview is based solely on the relevant information presented in the state application and/or resume submitted before the closing date.

Applications and/or resumes should include relevant work history which indicates your qualifications for this position.

The Department of Medical Assistance Services practices fair and equal employment opportunity to all employees and applicants in accordance with applicable laws and regulations. It is our policy to prohibit discrimination on the basis of race, sex, color, national origin, religion, sexual orientation, gender identity, age, veteran status, political affiliation, genetics, or disability in the recruitment, selection, and hiring of its workforce.

In support of the Commonwealth’s commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth's Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly called a Certificate of Disability) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans may also apply via the AHP if they also provide an AHP Letter. To request an AHP Letter, use this link: https://www.dars.virginia.gov/drs/cpid/PWContact.aspx or call DARS at 800-552-5019, or DBVI at 800-622-2155

The Department of Medical Assistance Services is a V3 certified state agency that provides hiring preference to veterans and members of the reserves and/or National Guard in support of executive order 29, (2010). If you are a Veteran or Spouse of a Veteran or Active Military Member, DMAS encourages you to apply and respond accordingly on your state application.

Contact Information

Name: DMAS Talent Acquisition

Phone: (804)-225-4407

Email: askhcdtalentacq@dmas.virginia.gov

In support of the Commonwealth’s commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly COD) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their AHP Letter. Requesting an AHP Letter can be found at AHP Letter or by calling DARS at 800-552-5019.

Note: Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1, 2022- February 29, 2024, can still use that COD as applicable documentation for the Alternative Hiring Process.