Rate Development DirectorJob no: Work type: Full-Time (Salaried)
Location: Richmond (City), Virginia
Categories: Health and Human Services
Title: Rate Development Director
State Role Title: Gen Admin Manager III
Hiring Range: $164,705 - $175,529
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 DutiesThe Department of Medical Assistance Services (DMAS) is excited to offer a competitive opportunity to serve as the Rate Development Director in the Provider Rate Development Division.
Job responsibilities will include, but are not limited to:
Provides leadership across the following units within the Provider Reimbursement division: Managed Care Rate Setting, Provider Rate Setting, Supplemental Payments and Cost Settlement and Audit.
This position leads the design, implementation and oversight of reimbursement methodologies and fee schedules for healthcare providers and partners with internal and external actuaries to review capitation rate structures.
The position manages the determination of payments through supplemental payment and state-directed payments and manages the provider tax assessments.
The position also manages the settlement and auditing of institutional providers' cost reports and utilizing both regulatory and market information to determine appropriate and allowable payments.
This position reports directly to the Deputy Director of Finance / Chief Finance Officer (CFO) and provides management and strategic planning for all provider reimbursement programs for the Department of Medical Assistance Services, in accordance with state and federal laws and established policies and procedures.
This position requires a deep understanding of state and federal Medicaid policies, payments systems and healthcare reimbursement principles to ensure compliance with requirements on payment limits and rate adequacy.
This position develops, interprets and implements policy related to Medicaid reimbursement methodologies.
This position directs the analysis used to establish provider rates, serves as a liaison and chairs various work groups with provider associations and provides executive-level briefings.
During the annual General Assembly session, ensures accurate and timely responses on fiscal impact statements and coordinates with the Budget Division Director.
The business needs for this position have in office requirements to include but are not limited to attending in-person meetings and training, external meetings and occasional conferences and travel.
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 QualificationsCompetitive candidates will meet these minimum qualifications:
Considerable experience with Medicaid rate setting for managed care programs; fee-for-service programs; supplemental payments; cost settlements; program planning; and health care programs, including Medicaid.
Extensive experience developing processes and procedures for complex financial analysis; calculating fiscal impact of policy changes; analyzing complex data to draw conclusions; using data to make recommendations; and applying statistical and quantitative methods.
Extensive experience leading complex projects, from inception to completion.
Considerable experience in developing, creating, and implementing financial and health care programs and policies.
Considerable experience as power user of Excel, including utilizing advanced formulas and aggregating data using PowerQuery, PowerPivot as well as pivot tables.
Considerable knowledge of state and federal regulatory processes and applying regulations, law, and policy to financial model development.
Considerable experience in meeting deadlines.
Considerable experience communicating with internal and external stakeholders.
Considerable experience in developing, creating, and implementing financial and health care programs and policies.
Considerable experience in supervisory and human resource management.
Considerable experience in program management and directing direct multiple, diverse operations.
Additional ConsiderationsThere are no additional considerations for this position.
Special InstructionsYou 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 InformationName: DMAS Talent Acquisition
Phone: 804 - 225 - 4407
Email:
[email protected]Advertised: 03 Sep 2026 Eastern Daylight Time
Applications close: 17 Sep 2026 Eastern Daylight Time
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