Medicare – Medicaid Integration Monitor

Virginia Information Technologies Agency • Richmond, VA

4d

About The Position

The Department of Medical Assistance Services (DMAS) is excited to offer a
competitive opportunity to serve as the Medicare – Medicaid Integration Monitor
in the Integrated Care Division.

Job responsibilities will include, but are not limited to:

The chief objective of this position is to ensure compliance of Dual-Eligible
Special Needs Plans (DSNP) and Medicaid Managed Care Organization (MCO) with
state and federal regulations and the DSNP and MCO contract requirements
pertaining to Medicare-Medicaid integration activities.

This position will also provide operational oversight of Medicare Medicaid
integration activities of programs that enroll our dual-eligible (enrolled in
both Medicare and Medicaid) population.

This position will work closely with staff across the Department, to create and
implement operational oversight and compliance monitoring plans.

This position is responsible for providing reports to management and providing
technical expertise to stakeholders when needed.

The business needs for this position have in office requirements to include but
are not limited to requiring limited travel (intra- and inter-state) for
meetings, conferences, and/or training.

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.

Requirements

• Experience with Medicaid and/or Medicare Managed Care programs.
• Experience with contract monitoring or quality management.
• Experience with Medicaid and/or Medicare managed care contract development.
• Experience with operational oversight within the health care services section.
• Experience with Microsoft Office Suite.
• Experience analyzing, interpreting, and applying state and/or federal regulations and laws.
• Experience demonstrating organizational skills and meeting deadlines.
• Experience communicating and collaborating with diverse internal and external stakeholders.

Responsibilities

• ensure compliance of Dual-Eligible Special Needs Plans (DSNP) and Medicaid Managed Care Organization (MCO) with state and federal regulations and the DSNP and MCO contract requirements pertaining to Medicare-Medicaid integration activities
• provide operational oversight of Medicare Medicaid integration activities of programs that enroll our dual-eligible (enrolled in both Medicare and Medicaid) population
• work closely with staff across the Department, to create and implement operational oversight and compliance monitoring plans
• providing reports to management and providing technical expertise to stakeholders when needed

What This Job Offers

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