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Check with seller Medicaid Operations Administrator Burlington

Published date: April 3, 2022
  • Location: Burlington, Vermont, United States

The Department of Vermont Health Access (DVHA)'s mission is to improve the health and well-being of Vermonters by providing access to quality healthcare cost effectively. We have three priorities that support us in moving our mission forward: Adoption of value-based payments, management of information technology projects, and operational performance improvement. Our department commits to executing our responsibilities and priorities while adhering to three core values: Transparency, Integrity and Service.

DVHA's Reimbursement Unit is seeking a qualified individual to join their dynamic team.

The Medicaid Operations Administrator in the Reimbursement Unit will plan, direct and coordinate annual rate updates and/or major policy changes to existing or new payment methodologies for programs administered under the Department of Vermont Health Access (DVHA). Duties may also include collaboration efforts and the sharing of reimbursement expertise with other Agency of Human Services departments in efforts to update their reimbursement rates and methodologies for existing or new programs. Other major duties may include the gathering of data and the calculation of annual payments to hospitals for services provided to uninsured individuals or to academic teaching hospitals to train the new medical professionals.

The activities of this position involves developing subject matter expertise for a subset of the following Medicaid reimbursement methodologies and payment programs: Inpatient or Outpatient Hospital, Professional Services, Durable Medical Equipment, Federally Qualified Health Centers, Home Health and Hospice, Dental, Disproportionate Share Hospital payments, Direct Graduate Medical Education payments, and other new or established programs. This position will interpret existing federal and state policies and procedures, perform fiscal analysis and rate modeling, and evaluate and analyze programmatic impact of proposed regulatory and policy changes. This position will also review and prepare updates to the Medicaid State Plan and provider manuals, work with the State's fiscal agent on system changes, and prepare and monitor the posting of information about policy changes for public comment. Other areas of work may include assistance with the resolution of claims issues, timely filing review, calculation of provider taxes, negotiating and preparing special rate agreements, calculating manual and enhanced pricing, and assisting with legislative bill review and analysis. This position requires an articulate collaborator who is able to garner cooperation and support of a diverse group of individuals and organizations.
Who May Apply
This position, Medicaid Operations Administrator (Job Requisition #31142) , is open to all State employees and external applicants.

If you would like more information about this position, please contact .

Resumes will not be accepted via e-mail. You must apply online to be considered.

Please note that multiple positions in the same work location may be filled from this job posting.

AHS BACKGROUND CHECKS: Candidates must pass any level of background investigation applicable to the position. In accordance with AHS Policy 4.02, Hiring Standards, Vermont and/or national criminal record checks, as well as DMV and adult and child abuse registry checks, as appropriate to the position under recruitment, will be conducted on candidates, with the exception of those who are current classified state employees seeking transfer, promotion or demotion into an AHS classified position or are persons exercising re-employment (RIF) rights.
Class Definition
Planning, administrative, supervisory and technical work involving the Operations Unit of the Medicaid Division of the Department for Children & Families or the Office of Vermont Health Access. Duties involve the operation of the Medicaid Management Information system, payment authorization for the fiscal agent and other Medicaid contractors, assignment of proper codes, and authorization of services. Supervision is exercised over professional, technical and clerical employees. Work is performed under the general direction of an administrative supervisor.
Environmental Factors
Duties are performed largely in standard office setting but with predictable need for field travel for which private means of transportation must be available. The role may require performance of duties outside of the normal workday and workweek. Interaction with state and federal officials is frequent. Meetings with providers, fiscal agent, and interested publics may illicit strong feelings and create stressful situations.
Minimum Qualifications
Bachelor's degree AND four (4) years or more at or above a technical or professional level in health, welfare, mental health, or social services INCLUDING one (1) year or more of supervisory experience in any field.


Master's degree work in a human services or administration field AND two (2) years or more at or above a technical or professional level in health, welfare, mental health, or social services INCLUDING one (1) year or more of supervisory experience in any field.


Two years of full-time college coursework OR associate's degree AND six (6) years or more at or above a technical or professional level in health, welfare, mental health, or social services INCLUDING one (1) year or more of supervisory experience in any field.


High School diploma or equivalent AND eight (8) years or more at or above a technical or professional level in health, welfare, mental health, or social services INCLUDING one (1) year or more of supervisory experience in any field.
Preferred Qualifications
College degree in the areas of human services, business administration or public administration.
Total Compensation As a State employee you are offered a great career opportunity, but it's more than a paycheck. The State's total compensation package features an outstanding set of employee benefits that are worth about 30% of your total compensation, including:

80% State paid medical premium

Dental Plan at no cost for employees and their families

Flexible Spending healthcare and childcare reimbursement accounts

Two ways to save for your retirement: A State defined benefit pension plan and a deferred compensation 457(b) plan

Work/Life balance: 11 paid holidays each year and a generous leave plan; many jobs also allow for a flexible schedule

Low cost group life insurance

Tuition Reimbursement

Incentive-based Wellness Program

Qualified Employer for Public Service Student Loan Forgiveness Program

Want the specifics? Explore the Benefits of State Employment on our website. Equal Opportunity Employer The State of Vermont celebrates diversity, and is committed to providing an environment of mutual respect and meaningful inclusion that represents a variety of backgrounds, perspectives, and skills. The State does not discriminate in employment on the basis of race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, membership in an employee organization, family medical history or genetic information, or family or parental status. The State’s employment decisions are merit-based. Retaliatory adverse employment actions by the State are forbidden.

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