Title: Managed Care Network Adequacy Analyst
State Role Title: Prog Admin Specialist II
Hiring Range: $72,100 - $83,059
Pay Band: 5
Agency: Dept of Med Assistance Svcs
Location: Richmond City
Agency Website: www.dmas.virginia.gov
Recruitment Type: General Public - G

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.

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 Department’s MCOs, the provider enrollment contractor, and internal DMAS subject matter experts to ensure compliance with federal and state requirements for network adequacy.
As an employee of DMAS you are entitled to the many comprehensive benefits the Commonwealth has to offer. This includes health benefits, 12 paid holidays, paid leave, flexible work schedules, & retirement plans. For more specific details please visit: https://www.dhrm.virginia.gov/employeebenefits
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.