Division Director of Managed Care Organization (MCO) Performance
Job no:
Work type: Full-Time (Salaried)
Location: Richmond (City), Virginia
Categories: Health and Human Services
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 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/
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.
Contact Information
Name: DMAS Talent Acquisition
Phone: 804 - 225 - 4407
Email: askhcdtalentacq@dmas.virginia.gov
Advertised: 02 Nov 2026 Eastern Standard Time
Applications close: 18 Nov 2026 Eastern Standard Time
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