Division Director of Managed Care Organization (MCO) Performance

Title: Division Director of Managed Care Organization (MCO) Performance

State Role Title: Gen Admin Manager III

Hiring Range: $164,705 - $182,920

Pay Band: 7

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 Division Director of Managed Care Organization (MCO) Performance in the Healthcare Analytics & Transformation Division.

Job responsibilities will include, but are not limited to:

The Division Director of Managed Care Organization (MCO) Performance provides leadership and oversight for the quality, compliance, and regulatory assurance functions associated with Virginia Medicaid's managed care delivery system.

The Director is responsible for establishing and maintaining a comprehensive framework to assess Medicaid Managed Care Organization (MCO) performance, ensure compliance with federal and state requirements and contractual obligations, monitor quality and health outcomes, and provide independent oversight of managed care program performance.

The Division Director provides oversight of the External Quality Review Organization (EQRO), including procurement and contract management, review activities, performance measurement, validation activities, quality strategy requirements, and follow-up on EQRO findings and recommendations.

The Director also serves as a point of contact for Centers for Medicare & Medicaid Services (CMS) engagement related to managed care quality and compliance, coordinating agency responses to CMS oversight, monitoring activities, corrective actions, federal requirements, and other regulatory matters.

The position works closely with the Cardinal Care Managed Care (CCMC) Division, Health Analytics, Program Integrity, MCOs, EQRO, CMS, and other federal and state partners.

The business needs for this position have in office requirements to include but are not limited to conducting the in-person training and/or meetings, and engaging with internal and external stakeholders.

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:

Extensive experience in Medicaid, public sector or a related field.

Extensive experience with managing complex contracts.

Extensive experience leading complex quality, compliance, and/or regulatory programs.

Experience with CMS Managed Care Requirements and Federal Oversight.

Considerable experience utilizing Microsoft Office Products.

Extensive experience analyzing, interpreting, and applying federal, state laws/regulations.

Extensive experience with meeting deadlines.

Extensive experience engaging with executive leadership, government agencies, vendors, providers, community organizations, and other stakeholders.

Extensive experience managing staff.

Extensive experience managing complex organizational operations.

Additional Considerations

Competitive candidates should meet these additional considerations:

Experience managing an EQRO or similar external oversight organization.

Experience with Medicaid quality strategies and performance measurement.

Experience with MCO compliance monitoring and corrective action.

Experience participating in CMS audits, reviews, or monitoring activities.

Experience developing and implementing quality improvement strategies.

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, to include participation in STEM-OPT programs or similar programs. 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.

This position requires the submission of a Statement of Economic Interest (financial disclosure).

If you wish to apply for a job with the Department of Medical Assistance Services, an application and/or resume for employment must be submitted electronically through this website. Mailed, faxed, emailed, or hand-delivered applications/resumes will not be accepted. Consideration for an interview is based solely on the relevant information presented in the state application and/or resume submitted before the closing date.

Applications and/or resumes should include relevant work history which indicates your qualifications for this position.

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.

In support of the Commonwealth’s commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth's Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly called a Certificate of Disability) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans may also apply via the AHP if they also provide an AHP Letter. To request an AHP Letter, use this link: https://www.dars.virginia.gov/drs/cpid/PWContact.aspx or call DARS at 800-552-5019, or DBVI at 800-622-2155

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.

Contact Information

Name: DMAS Talent Acquisition

Phone: 804 - 225 - 4407

Email: askhcdtalentacq@dmas.virginia.gov

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 AHP Letter 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.

Advertised: 02 Nov 2026 Eastern Standard Time
Applications close: 18 Nov 2026 Eastern Standard Time

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