Healthcare Rate Setting Analyst

Job no:
Work type: Full-Time (Salaried)
Location: Richmond (City), Virginia
Categories: Health and Human Services

Title: Healthcare Rate Setting Analyst

State Role Title: Financial Services Spec III

Hiring Range: $100,545 - $112,742

Pay Band: 6

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

Job responsibilities will include, but are not limited to:

The position works within the Fee-For-Service Rate Setting Unit within the Provider Rate Development Division and reports to the Healthcare Reimbursement Manager.

The position will serve as a subject matter expert for Medicaid rate development for one or more provider types such as long-term care, acute care, HCBS, etc.

May provide peer assistance in specialty areas.

Works both independently and as part of a team within existing guidelines and policies.

Serves as a resource to others in resolving more complex problems.

This position is responsible for developing complex and highly technical payment policy analyses for Medicaid and other programs administered by the Department of Medical
Assistance Services.

The incumbent serves as support staff in the development, review, and evaluation of methods and policies for rate setting and rate development.

The business needs for this position have in office requirements to include but are not limited to in-person meetings and trainings

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:

Considerable work-related experience and knowledge in developing and completing complex financial analyses in an accurate and timely manner.

Considerable work-related knowledge and experience researching and solving complex issues and problems including knowledge of healthcare resource research and be able to apply these principles in practice.

Considerable work-related knowledge and experience in the application of statistics, quantitative methods, qualitative methods, and data science. Must be able to translate data into a graphic or visual representation.

Considerable work-related knowledge and experience in financial analysis, rate development, or actuarial science.

Considerable work-related knowledge and experience with calculating fiscal impacts of rate and policy changes.

Considerable experience using Excel, SAS, or SQL for developing complex analysis, aggregating data, drawing conclusions, and developing recommendations.

Considerable work-related knowledge of state and federal healthcare laws and regulatory processes.

Considerable experience meeting deadlines.

Considerable experience with communication with internal and external stakeholders including collaborating with other divisions and stakeholders to ensure proper implementation of business solutions.

Considerable experience maintaining system protocols in writing by updating processes, procedure documentation, and training materials.

Conducting regular audits and quality checks to ensure data integrity, troubleshoot data-related issues, and proposing solutions.

Additional Considerations

Competitive candidates should meet these additional considerations:

Knowledge of rate setting methodologies used by government and private purchasers of health care services such as DRG, EAPG, RUG, PDPM, and rate models.

Healthcare rate setting policy analysis, development, and interpretation experience.

Considerable experience with critical thinking and problem-solving skills, maturity of judgment, and comfort with on-demand decision-making to resolve problems, and to seek support when needed.

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.

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: [email protected]

Advertised: 16 Jul 2026 Eastern Daylight Time
Applications close: 30 Jul 2026 Eastern Daylight Time

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