Eligibility Projects Analyst

DHRM • Richmond, VA

5d • Hybrid

About The Position

The Department of Medical Assistance Services (DMAS) is excited to offer a competitive opportunity to serve as the Eligibility Projects Analyst in the Eligibility and Enrollment Division. The position serves as a subject matter expert on projects for assigned eligibility and enrollment initiatives involving business analysis, data research, systems analysis, enrollment reviews, reporting, and business process improvements. The incumbent ensures that member eligibility and enrollment functions within the Medicaid Enterprise System (MES), Virginia Case Management System (VaCMS), and any successor systems accurately support Medicaid and FAMIS eligibility policies, federal and state requirements, and program operations. Responsibilities include leading system enhancement efforts by developing business requirements, initiating and managing system change requests, collaborating with internal and external stakeholders—including the Virginia Department of Social Services (VDSS), contractors, and business partners—to design, implement, and validate system changes. The position develops business scenarios, test cases, and user acceptance testing (UAT) scripts to ensure system functionality meets business and policy requirements. The business needs for this position have in office requirements to include but are not limited to attending internal meetings, external stakeholder meetings, and occasional conference attendance. Located in beautiful Central Virginia, the Richmond area puts you just 2 hours from the Blue Ridge Mountains, Virginia Beach and Washington DC. 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.

Requirements

• Considerable knowledge of determining eligibility enrollments for the public assistance program Medicaid to include (Aged, Blind, and Disabled (ABD), Children's Health Insurance Program (CHIP), Family Access to Medical Insurance Security (FAMIS).
• Considerable knowledge of and experience working with the Virginia Case Management System (VaCMS).
• Considerable knowledge of and experience working with the Medicaid Enterprise System (MES) or any successor Medicaid eligibility and enrollment system.
• Considerable experience conducting Medicaid policy research, systems analysis, and evaluating business requirements.
• Considerable proficiency using Microsoft Office applications, including Excel, Word, PowerPoint, and Outlook.
• Considerable knowledge of and experience interpreting and applying federal and state Medicaid laws, regulations, policies, and procedures.
• Considerable experience working in a fast-paced environment with competing priorities, demonstrating the ability to effectively manage multiple assignments and meet established deadlines.
• Experience collaborating with internal and external stakeholders, including state agencies, vendors, and business partners, to resolve issues and implement business solutions.
• Considerable experience providing technical and programmatic guidance to internal and external stakeholders regarding Medicaid and FAMIS eligibility and enrollment.
• Experience creating and executing User Acceptance Testing (UAT) scenarios, test scripts, and defect documentation.

Nice To Haves

• Experience serving as a business analyst or project lead for Medicaid eligibility and enrollment system initiatives.
• Knowledge of the Centers for Medicare & Medicaid Services (CMS) regulations, federal mandates, and Medicaid Enterprise System (MES) modernization initiatives.
• Experience interpreting federal and state Medicaid policy and translating policy into business and system requirements.

Responsibilities

• Serve as a subject matter expert on projects for assigned eligibility and enrollment initiatives involving business analysis, data research, systems analysis, enrollment reviews, reporting, and business process improvements.
• Ensure that member eligibility and enrollment functions within the Medicaid Enterprise System (MES), Virginia Case Management System (VaCMS), and any successor systems accurately support Medicaid and FAMIS eligibility policies, federal and state requirements, and program operations.
• Lead system enhancement efforts by developing business requirements, initiating and managing system change requests.
• Collaborate with internal and external stakeholders—including the Virginia Department of Social Services (VDSS), contractors, and business partners—to design, implement, and validate system changes.
• Develop business scenarios, test cases, and user acceptance testing (UAT) scripts to ensure system functionality meets business and policy requirements.
• Attend internal meetings, external stakeholder meetings, and occasional conference attendance.

Benefits

• Telework arrangements are a privilege and may be rescinded at any time based on performance and/or business need.
• The agency reserves the right to modify or terminate a telework arrangement, provided that reasonable notice is given to the employee.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed