Managed Care Network Adequacy Analyst
Managed Care Network Adequacy Analyst
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Job Description
Title: Managed Care Network Adequacy Analyst
State Role Title: Prog Admin Specialist II
Hiring Range: $72100 $83059
Pay Band: 5
Agency: Dept of Med Assistance Svcs
Location:Richmond City
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 Managed Care Network Adequacy Analyst in the Health Care Services Division.
Job responsibilities will include but are not limited to:
The Chief Objective of the Managed Care Network Adequacy Analyst is to conduct the oversight of managed care health plan provider networks with the goal of ensuring adequacy access and availability to covered services for Medicaid and FAMIS members.
This role involves working closely with the Departments MCOs the provider enrollment contractor and internal DMAS subject matter experts to ensure compliance with federal and state requirements for network adequacy.
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: 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 the principles and practices of Medicare Managed Care/Medicaid or Commercial health insurance.
Considerable experience with contractual agreements performance monitoring or regulatory compliance.
Experience with health care provider network management and network adequacy analysis and reporting.
Experience conducting research independently evaluate results and report on outcomes.
Experience using Excel Word Visio and PowerPoint and/or data management software to analyze provider networks.
Experience interpretating federal state laws/regulation.
Experience in meeting deadlines.
Experience with internal/external stakeholders.
Considerable experience presenting reports to various levels of leadership.
Additional Considerations
Competitive candidates should meet these additional considerations:
Knowledge of the federal and state regulations for managed care network adequacy and timely access to care standards.
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.
Required Experience:
IC
Employment Type
Full-Time
