Quality Management Review Analyst

Title: Quality Management Review Analyst

State Role Title: Health Care Compliance Spec II

Hiring Range: $59017 $78127

Pay Band: 5

Agency: Dept of Med Assistance Svcs

Location:Dept of Medical Asst Services

Agency Website:

Recruitment Type: General Public G

Job Duties

The Department of Medical Assistance Services (DMAS) is excited to offer a competitive opportunity to serve as a Quality Management Review Analyst. The selected competitive candidate will provide exceptional delivery of services to the agencys High Needs Support/QMR Unit.

Job responsibilities will include but are not limited to:

Quality Management Review (QMR) Analysts will have frequent overnights completing onsite reviews and could also spend up to three to four overnights a week for three to four weeks of a month.

QMR Analysts will work in the field to conduct onsite quality management reviews to assure the health safety and welfare of individuals receiving Medicaid LongTerm Care Services through home and communitybased waiver programs.

Programs reviewed include and are not limited to: Family and Individual Supports Waiver Building Independence Waiver and Community Living Waiver.

Based on the findings of the QMR we may make a referral to the proper agency in most cases.

Staff will make decisions regarding health welfare & safety of waiver enrollees documentation compliance and verify services were rendered.

Staff provides training and/or technical assistance to providers and participate as subject matters experts in policy/procedure development.

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:

The Department of Medical Assistance Services (DMAS) is working to improve the health and wellbeing 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 the Developmental Disabilities Waivers and personcentered planning.

Considerable knowledge reviewing medical record and applying applicable regulations and generating letters reflecting the results of the reviews.

Knowledge of electronic health records; project management; standards of treatment and medical terminology.

Knowledge of analyzing data and resolving problems; researching and identifying changes in program requirements and policies.

Knowledge of the use of personal computers word processing and spreadsheet applications (Microsoft Suites).

Knowledge/Experience interpretation and application of federal state laws/regulations.

Experience in meeting deadlines.

Experience with internal/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 rsum 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 employmentbased Sponsorship. Selected candidates will have their work authorization completed using the EVerify Program.

The Department of Medical Assistance Services (DMAS) is an Executive Branch agency that will adhere to all policies and procedures to include the Commonwealths 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 handdelivered 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 Commonwealths commitment to inclusion we are encouraging individuals with disabilities to apply through the Commonwealths 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). ServiceConnected Veterans may also apply via the AHP if they also provide an AHP Letter. To request an AHP Letter use this link: or call DARS ator DBVI at

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:

Email:

In support of the Commonwealths 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). ServiceConnected 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.

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.