Medical Support Unit Nurse Supervisor

Title: Medical Support Unit Nurse Supervisor

State Role Title: Prog Admin Manager III

Hiring Range: $100332 $114330

Pay Band: 6

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 the Medical Support Unit Nurse Supervisor in the Office of the Chief Medical Officer.

Job responsibilities will include but are not limited to:

Active Registered Nursing (RN) license in the Commonwealth of Virginia.

This position is responsible for management and oversight of maintaining and developing clinical policies and policy documents on behalf of the Medical Support Unit (MSU) within the Office of the Chief Medical Officer.

This position provides supervision and oversight to clinical authorization review within the Feeforservice (FFS) program reviews and evaluates new Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) billing codes and helps to oversee aspects of clinical policy development.

Communicates in writing and verbally with providers updates corresponding Medicaid manuals and issues agency wide recommendations on issues associated with claims payments rate issues internal adjudication processes billing procedures and other functions as assigned.

Provides Division Director support on policy and procedural issues. Creates decision briefs project plans studies and analyses as needed.

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:

Knowledge of thirdparty health care delivery systems.

Knowledge of and experience using utilization management resources (e.g. InterQual or MCG) to adhere to utilization management guidelines (i.e. NCQA).

Considerable work experience with billing codes (i.e. CPT/HCPCS) and determining coverage criteria.

Considerable knowledge of and experience interpreting evidencebased clinical guidelines.

Considerable work experience developing programs to resolve complex issues.

Experience utilizing Microsoft Office products.

Knowledge of and workrelated experience analyzing interpreting and applying federal/state laws and regulations governing the administration of public payer programs (i.e. Medicare Medicaid).

Experience adhering to deadlines.

Experience communicating and collaborating with internal/external stakeholders.

Working experience managing directing and evaluating the work of reports

Additional Considerations

Competitive candidates should meet these additional considerations:

Experience with state rules and regulations relating to the Commonwealth of Virginia and Department of Medical Assistance Services.

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.

This position requires the submission of a Statement of Economic Interest (financial disclosure).

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.