• Medicaid Programs Specialist

    Job Locations US-VA-Glen Allen
    Job ID
  • About Us

    Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.
    By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.
    At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.
    If this sounds like you, read on!


    The Medicaid Programs Specialist is responsible for assisting and supporting with all aspects of Virginia Premier Health Plan’s Medicaid line of business.  They will assist with the coordination of all facets of the program, administration and implementation of program development and compliance. The Specialist will interface with the corporate Initiative Management Team (IMT) and project leads across operational areas, along with Compliance areas to ensure all operational activities are compliant with state and federal requirements.



    • Assist the department leadership with overseeing various operational business areas ensuring the Medicaid plan performance is consistent with the Department of Medical Assistance Services (DMAS) regulatory requirements.
    • Assist the operational leads to ensure all state and federal requirements are implemented timely and correctly.
    • Provides support for the day to day operations of the Medicaid product line to support continued growth and ability to meet regulatory and contractual obligations
    • Works closely with the operational area to inform business areas of new requirements and changes to existing requirements.  
    • Provides functional and technical support regarding the Medicaid product requirements.
    • Assist with facilitating the development of various reporting tools to monitor operational functions and identify opportunities for improved performance, including development and analysis of reports.
    • Tracks and reports product key performance indicators as requested.
    • Monitor issues across all areas of the program and ensures that proper documentation and resolution occur.
    • Provide subject matter expertise in Medicaid Program benefits and facilitate alignment between business areas and systems
    • Other duties as assigned



    • Associate or Bachelor’s Degree highly preferred
    • Two years of assisting with projects or related experience preferred


    • Working knowledge of Federal and State policy initiatives that relate to the care and funding of those who qualify for Medicaid and/or MLTSS
    • Demonstrated experience and effectiveness in motivating and leading.
    • Proficient in Microsoft Office computer applications such as Excel, Outlook, Word, and Power Point.
    • Exceptional interpersonal, written, verbal and presentation communication skills. 


    • A minimum of one (1) year experience in managed care operations, project management, or related experience required.
    • Minimum of (2) years of healthcare experience preferred.


    • Physical health sufficient to meet the ergonomic standards and demands of the position


    All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE


    Our mission is to inspire healthy living within the communities we serve!


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