Cover VA Eligibility Manager

Dept of Med Assistance Svcs; Richmond (VA); On-site; USD 99,000 - 110,000; Full time

Job summary

The Department of Medical Assistance Services (DMAS) invites qualified candidates to apply for the Cover VA Eligibility Manager role in the Eligibility & Enrollment Services Division in Richmond, VA. You will oversee eligibility monitoring, policy development for the Cover Virginia contract, and report to the Program Operations Manager.

The position leads two contract monitors and oversees operations of the CPU, Cardinal Care Correspondence Center, Renewal Processing Unit, Federal Work

Qualifications

• Considerable knowledge/experience of the Medicaid/FAMIS programs, Virginia Insurance Marketplace, and the health care and social needs of families and children.
• Experience with eligibility processing systems such as VaCMS, MES, and other required state systems.
• Experience in Medicaid eligibility policy.
• Experience with program implementation, developing processes and procedures, and project management.
• Proficiency in Word, Outlook, Excel, PowerPoint, web research, and general computer skills.
• Knowledge of interpreting federal and state laws/regulations.
• Experience meeting deadlines.
• Experience with internal/external stakeholders.
• Experience managing team members and collaborating across functions.
• Experience interpreting data, compiling reports, and presenting to stakeholders.

Responsibilities

• Oversee eligibility monitoring and policy subject matter for the Cover Virginia contract, reporting to the Program Operations Manager.
• Direct oversight of two contract monitors and operations of the CPU, Cardinal Care Correspondence Center, Renewal Processing Unit, Federal Work Requirements, and Cover Virginia Appeals.
• Attend internal meetings, external meetings, and vendor offsite visits.

Skills

Medicaid/FAMIS knowledge

Policy development

Project management

Stakeholder management

Microsoft Office proficiency

Data interpretation & reporting

Meeting deadlines

Team leadership

Tools

VaCMS

MES

Contract management systems

Job description

Title: Cover VA Eligibility Manager

State Role Title: Prog Admin Manager II

Hiring Range: $98,790 - $110,052

Pay Band: 5

Agency: Dept of Med Assistance Svcs

Location: Dept of Medical Asst Services

Agency Website: www.dmas.virginia.gov

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 Cover VA Eligibility Manager in the Eligibility & Enrollment Services Division.

Job responsibilities will include, but are not limited to:

This position is responsible for overseeing eligibility monitoring and eligibility policy subject matter for the Cover Virginia contract, reporting into the Program Operations Manager.

This role will have direct oversight over two contract monitors, overseeing operations of the CPU, Cardinal Care Correspondence Center, Renewal Processing Unit, Federal Work Requirements, and Cover Virginia Appeals processes.

The business needs for this position have in office requirements to include but are not limited to attending internal meetings, external meetings, and vendor offsite visits.

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.

Minimum Qualifications

Competitive candidates will meet these minimum qualifications:

Considerable work-related knowledge/experience of the Medicaid/FAMIS programs, Virginia Insurance Marketplace, and the health care and social needs of families and children.

Considerable work-related knowledge/experience eligibility processing systems such as/including Virginia Case Management System (VaCMS), Medicaid Enrollment System (MES), and other required state eligibility systems (or comparable systems).

Considerable work-related knowledge/experience in Medicaid eligibility policy.

Considerable work-related knowledge/experience with program implementation, development of processes and procedures, and project management/planning.

Considerable work-related knowledge/experience with Microsoft Word, Outlook, Excel, Powerpoint, Web-based browsing and research, and computer proficiency.

Considerable knowledge/experience with the interpretation and application of federal, state laws/regulations.

Considerable demonstrated knowledge/experience in meeting deadlines.

Considerable experience with internal/external stakeholders.

Considerable experience in managing team members and working collaboratively across functions, departments, levels, and teams.

Considerable knowledge/experience interpreting data, reading/compiling reports, and presenting to a variety of stakeholders, leaders, and members of the community.

Additional Considerations

Competitive candidates should meet these additional considerations:

Considerable knowledge/experience in performing system readiness testing and documentation of expected and actual results and working as a project team lead to effectively work with project stakeholders.

Considerable knowledge/experience of contract and vendor management.

Considerable knowledge/experience delivering presentations, leading meetings, and driving results.

Contact Information

Name: DMAS Talent Acquisition

Phone: 804 - 225 - 4407

Email: [e-mail]

In support of the Commonwealth’s 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). Service-Connected 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 https://www.dars.virginia.gov/drs/cpid/PWContact.aspx or by calling DARS at 800-552-5019.

The Virginia Department of Medical Assistance Services (DMAS) does not offer employment-based Sponsorship. Selected candidates will have their work authorization completed using the E-Verify Program.

The Department of Medical Assistance Services (DMAS) is an Executive Branch agency that will adhere to all policies and procedures, to include the Commonwealth’s Department of Human Resource Management Policy 1.61 Teleworking. This position could be expected to work in the office as driven by business needs.

Telework arrangements are a privilege and may be rescinded at any time based on performance and/or business need. The agency reserves the right to modify or terminate a telework arrangement, provided that reasonable notice is given to the employee.

This position requires a fingerprint based Criminal History Background Check, Education Checks if applicable, Work History Verification with references.

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.

From July 1, 2026, through January 21, 2029, applicants who were involuntarily separated from employment with the Federal Government on or after January 1, 2025, due to a reduction in force, budget reduction, or workforce restructuring initiative may be eligible for HB494 Federal Employee Priority Consideration. Applicants seeking HB494 Federal Employee Priority Consideration must identify themselves within the state application process and provide supporting documentation, including a Standard Form 50 (SF-50), verifying their eligibility.

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.

In support of the Commonwealth’s 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). Service-Connected 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 https://www.dars.virginia.gov/drs/cpid/PWContact.aspx or by calling DARS at 800-552-5019.

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.