Registered Nurse (RN) Clinical Analyst

Job Duties

The Department of Medical Assistance Services (DMAS) is excited to offer a competitive opportunity to serve as the Registered Nurse (RN) Clinical Analyst in the Integrated Care Division.

Job responsibilities will include, but are not limited to:

Responsible for clinical responsibilities of the level of care review (LOCERI) process.

This includes providing secondary or higher level reviews, data collection, data entry, communications with providers (Managed Care Organization (MCO) & Fee for Service (FFS)).

Training of providers and representing Department of Medial Assistance (DMAS) in appeals associated with LOCERI.

The incumbent will be responsible will be responsible for clinical responsibilities of the Level of Care Review (LOCERI) process.

The incumbent will have Frequent contact with health care providers, program administrators, and representatives from state and federal agencies, and other direct and indirect human service providers to confer on policy problems and request legal opinions.

This position will apply rules, regulations, and laws in administration of programs.

As well as implementing and overseeing corrective actions.

Lastly, this position renders decisions on unusual problems involving policy interpretation.

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.