Commonwealth of VA Careers
Senior Systems Analyst for Encounters
Commonwealth of VA Careers, Richmond, Virginia, United States, 23214
Overview
Title:
Senior Systems Analyst for Encounters State Role Title:
Info Technology Specialist III Hiring Range:
$108,879 - $112,800 Pay Band:
6 Agency:
Dept of Medical Assistance Services Location:
Dept of Medical Assistance Services Agency Website:
dm as.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 Senior Systems Analyst for Encounters in the Integrated Care Division. Integrated Care Division (IC) subject matter expert for encounters. Serve as the primary representative for the creation of the data analytics solution to measure encounter completeness. Oversee, coordinate, and monitor all Cardinal Care Managed Care (CCMC) encounter submissions for CCMC contractors. Ensure compliance of encounter submissions with all CCMC contractual requirements and with all current EDI and HIPAA standards. Develop and maintain innovative and effective procedures to assess vendor submission compliance and encounter data quality. The business needs for this position may be completed virtually. Located in Richmond, central Virginia. The area offers access to nearby attractions and regions (e.g., Blue Ridge Mountains, Virginia Beach, Washington DC). DMAS aims to improve the health and well-being of Virginians through access to high quality health care coverage. We seek individuals who can align their experience with the agency mission and core values: service, collaboration, trust, problem solving, and adaptability. Our promise is: Come as you are | Become who you want to be. Minimum Qualifications
Competitive candidates will meet these minimum qualifications: Considerable technical and industry knowledge of current healthcare Electronic Data Interchange (EDI) processing standards. Considerable knowledge of encounter processing. Considerable knowledge of National Council for Prescription Drug Programs (NCPDP). Considerable knowledge of the principles and practices of healthcare claims payments. Considerable knowledge of a managed care delivery system. Considerable knowledge ensuring compliance with necessary rules, regulations, standards and laws. Experience in meeting deadlines. Experience with internal/external stakeholders. Extensive knowledge of Electronic Data Interchange (EDI) standards. Extensive knowledge of the Health Insurance Portability and Accountability Act (HIPAA), X12 837 transaction sets. Extensive knowledge of data extraction and analysis. Additional Considerations
Competitive candidates should meet these additional considerations: Considerable technical (SAS, SQL, etc.) skills. Special Instructions
You will be provided a confirmation of receipt when your application and/or résumé 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 employment-based Sponsorship. Selected candidates will have their work authorization completed using the E‑Verify Program. DMAS adheres to policies including Teleworking as per Commonwealth policy and may require in-office work based on business needs. This position requires a fingerprint-based Criminal History Background Check, Education Checks if applicable, and Work History Verification with references. It requires the submission of a Statement of Economic Interest (financial disclosure). Applications and/or resumes must be submitted electronically through the state website. Mailed, faxed, emailed, or hand-delivered applications/resumes will not be accepted. Interview consideration is based on the information presented in the application and resume prior to the closing date. Include relevant work history demonstrating qualifications. DMAS practices fair and equal employment opportunity in accordance with applicable laws. Discrimination on the basis of race, sex, color, national origin, religion, sexual orientation, gender identity, age, veteran status, political affiliation, genetics, or disability is prohibited. To support inclusion, individuals with disabilities may apply through the Commonwealth’s Alternative Hiring Process (AHP). To be considered, applicants should provide an AHP Letter from DARS or DBVI. Service-Connected Veterans may also apply via AHP with appropriate documentation. DMAS is a V3 certified state agency and provides hiring preference to veterans and reservists in support of executive orders. Veterans or their spouses are encouraged to apply and indicate status on the state application. Contact Information
Name: DMAS Talent Acquisition Phone: (804) 225-4407 Email: askhcdtalentacq@dmas.virginia.gov Note: Applicants should refer to the AHP process and relevant letters for disability considerations. See DARS/DBVI for the AHP Letter information and contact details for obtaining the letter.
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Title:
Senior Systems Analyst for Encounters State Role Title:
Info Technology Specialist III Hiring Range:
$108,879 - $112,800 Pay Band:
6 Agency:
Dept of Medical Assistance Services Location:
Dept of Medical Assistance Services Agency Website:
dm as.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 Senior Systems Analyst for Encounters in the Integrated Care Division. Integrated Care Division (IC) subject matter expert for encounters. Serve as the primary representative for the creation of the data analytics solution to measure encounter completeness. Oversee, coordinate, and monitor all Cardinal Care Managed Care (CCMC) encounter submissions for CCMC contractors. Ensure compliance of encounter submissions with all CCMC contractual requirements and with all current EDI and HIPAA standards. Develop and maintain innovative and effective procedures to assess vendor submission compliance and encounter data quality. The business needs for this position may be completed virtually. Located in Richmond, central Virginia. The area offers access to nearby attractions and regions (e.g., Blue Ridge Mountains, Virginia Beach, Washington DC). DMAS aims to improve the health and well-being of Virginians through access to high quality health care coverage. We seek individuals who can align their experience with the agency mission and core values: service, collaboration, trust, problem solving, and adaptability. Our promise is: Come as you are | Become who you want to be. Minimum Qualifications
Competitive candidates will meet these minimum qualifications: Considerable technical and industry knowledge of current healthcare Electronic Data Interchange (EDI) processing standards. Considerable knowledge of encounter processing. Considerable knowledge of National Council for Prescription Drug Programs (NCPDP). Considerable knowledge of the principles and practices of healthcare claims payments. Considerable knowledge of a managed care delivery system. Considerable knowledge ensuring compliance with necessary rules, regulations, standards and laws. Experience in meeting deadlines. Experience with internal/external stakeholders. Extensive knowledge of Electronic Data Interchange (EDI) standards. Extensive knowledge of the Health Insurance Portability and Accountability Act (HIPAA), X12 837 transaction sets. Extensive knowledge of data extraction and analysis. Additional Considerations
Competitive candidates should meet these additional considerations: Considerable technical (SAS, SQL, etc.) skills. Special Instructions
You will be provided a confirmation of receipt when your application and/or résumé 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 employment-based Sponsorship. Selected candidates will have their work authorization completed using the E‑Verify Program. DMAS adheres to policies including Teleworking as per Commonwealth policy and may require in-office work based on business needs. This position requires a fingerprint-based Criminal History Background Check, Education Checks if applicable, and Work History Verification with references. It requires the submission of a Statement of Economic Interest (financial disclosure). Applications and/or resumes must be submitted electronically through the state website. Mailed, faxed, emailed, or hand-delivered applications/resumes will not be accepted. Interview consideration is based on the information presented in the application and resume prior to the closing date. Include relevant work history demonstrating qualifications. DMAS practices fair and equal employment opportunity in accordance with applicable laws. Discrimination on the basis of race, sex, color, national origin, religion, sexual orientation, gender identity, age, veteran status, political affiliation, genetics, or disability is prohibited. To support inclusion, individuals with disabilities may apply through the Commonwealth’s Alternative Hiring Process (AHP). To be considered, applicants should provide an AHP Letter from DARS or DBVI. Service-Connected Veterans may also apply via AHP with appropriate documentation. DMAS is a V3 certified state agency and provides hiring preference to veterans and reservists in support of executive orders. Veterans or their spouses are encouraged to apply and indicate status on the state application. Contact Information
Name: DMAS Talent Acquisition Phone: (804) 225-4407 Email: askhcdtalentacq@dmas.virginia.gov Note: Applicants should refer to the AHP process and relevant letters for disability considerations. See DARS/DBVI for the AHP Letter information and contact details for obtaining the letter.
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