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Medicaid Program Manager Jobs in Virginia (NOW HIRING)

Access Star

Program Manager

Manassas, VA · On-site

Administers Medicaid Waiver services. * Schedules, trains, leads and evaluates the work of Group ... and manage the behaviors of program participants. Job Type: Full-time Benefits: * Employee ...

Maximus

Technical Project Manager

VA · On-site +1

General information Job Posting Title Technical Project Manager Date Tuesday, May 5, 2026 City ... The ideal candidate brings strong leadership capabilities and deep Medicaid program experience to ...

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All JobsMedicaid Program Manager JobsMedicaid Program Manager Jobs in Virginia

Medicaid Program Manager information

Does Medicaid cover Eliquis?

Medicaid coverage for Eliquis, a blood thinner used to prevent blood clots, varies by state and specific Medicaid program. As a Medicaid Program Manager, understanding state-specific formularies and prior authorization requirements is essential, as coverage may depend on medical necessity and approved indications.

Who is eligible for Medicaid?

Medicaid program managers need to understand that eligibility for Medicaid generally depends on income level, household size, and other factors such as age, disability, or pregnancy. In most cases, low-income individuals and families, children, pregnant women, seniors, and people with disabilities qualify for Medicaid coverage. Eligibility criteria can vary by state and may require documentation of income and residency.

What are the main challenges Medicaid Program Managers face in coordinating between state agencies and healthcare providers?

Medicaid Program Managers often navigate the complexities of aligning policies and procedures between state agencies and a diverse range of healthcare providers. Challenges can include managing frequent regulatory changes, ensuring compliance with both federal and state guidelines, and facilitating clear communication among stakeholders. Additionally, they must address provider concerns, resolve billing or service disputes, and adapt program initiatives to meet evolving healthcare needs. Strong organizational and relationship-building skills are essential to succeed in this collaborative and dynamic environment.

What does a Medicaid Program Manager do?

A Medicaid Program Manager oversees the administration and implementation of Medicaid programs at the state or organizational level. Their responsibilities include ensuring compliance with federal and state regulations, managing budgets, coordinating with stakeholders, and improving service delivery for Medicaid recipients. They often analyze data, develop policies, and work to enhance program efficiency and effectiveness. This role requires strong leadership, organizational, and policy analysis skills to ensure that eligible populations receive proper healthcare services.

What's the difference between Medicaid and Medicare?

A Medicaid Program Manager understands that Medicaid is a state and federally funded program providing health coverage for low-income individuals, while Medicare is a federal program primarily for people aged 65 and older or with certain disabilities. Medicaid often covers a broader range of services and has income-based eligibility, whereas Medicare offers standardized benefits regardless of income. Both programs require knowledge of healthcare policies, billing, and compliance standards relevant to managing public health programs.

What are the key skills and qualifications needed to thrive as a Medicaid Program Manager, and why are they important?

To thrive as a Medicaid Program Manager, you need expertise in healthcare administration, knowledge of Medicaid regulations, and a relevant degree such as public health or healthcare management. Familiarity with Medicaid Management Information Systems (MMIS), data analytics tools, and compliance software is typically expected. Strong leadership, problem-solving, and communication skills enable effective team management and stakeholder engagement. These skills ensure efficient program operation, regulatory compliance, and the delivery of quality services to beneficiaries.

What is the maximum income for Medicaid?

For a Medicaid Program Manager, understanding income limits is essential, as eligibility varies by household size and income. In Pennsylvania, the maximum income for Medicaid eligibility generally ranges from 138% to 200% of the federal poverty level, depending on the specific program and applicant category. These thresholds are updated annually and may differ for children, pregnant women, or disabled individuals.
What are popular job titles related to Medicaid Program Manager jobs in Virginia? For Medicaid Program Manager jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Medicaid Program Manager jobs in Virginia look for? The top searched job categories for Medicaid Program Manager jobs in Virginia are:
What cities in Virginia are hiring for Medicaid Program Manager jobs? Cities in Virginia with the most Medicaid Program Manager job openings:
Medicaid Program Manager jobs near you
Infographic showing various Medicaid Program Manager job openings in Virginia as of June 2026, with employment types broken down into 66% Full Time, 27% Part Time, and 7% Contract. Highlights an 93% In-person, and 7% Hybrid job distribution.

Program Manager

AccessStar Community Living Services

Manassas, VA

Full-time

PTO

Posted 15 days ago

Job description

Thank you for your interest in working at AccessStar Community Living Services Inc.

ACLS is seeking highly motivated individuals who want to make a positive difference in the lives of others.


OVERVIEW:Manages and provides direct care in the operation of a Group Home Facility providing residential care and programs on a 24/7 basis in service to the medical, physical, psychological and social needs and personal goals for intellectually disabled and developmentally disabled adults. Work is performed under general supervision and is guided by agency policies and procedures, quality assurance, state and federal licensure and accreditation regulations and guidelines and ethical standards related to client interactions.


DUTIES AND RESPONSIBILITIES

  • Oversees and participates in the supervision and direct care to residents including interviewing for progress assessments.
  • Administers Medicaid Waiver services.
  • Schedules, trains, leads and evaluates the work of Group Home staff.
  • Assesses the needs of residents through referrals and interviews.
  • Monitors compliance to state and local licensure standards.
  • Develops, implements and monitors individual service plans in collaboration with the residents, their families, and other service providers.
  • Prepares and maintains written and electronic documentation of individual service plans, phone contacts, requirements DBHDS requirements, and other information to meet program, agency, and licensure requirements.
  • Prepares and maintains appropriate reports, including needs lists, and monthly service statistics.
  • Transports residents.
  • Teaches residents basic living skills, including cooking, nutrition, and laundry, cleaning, and budgeting.
  • Provides crisis intervention.
  • Implements VHDA and HUD requirements and conducts related inspections for the group home.
  • Recruits and makes recommendations on hiring, terminations and evaluations.
  • Prepares payroll forms and performs other administrative duties related to staff.
  • Maintains facilities in compliance with appropriate building and health codes. Initiates building repairs and maintenance.
  • Monitors resident medication management and coordinates with group home staff, prescribing physicians and pharmacies.
  • Coordinates financial assistance, contact obligations, and other services with other agency staff members and external providers.
  • Makes recommendations and proposals regarding program issues, resource needs, policies and procedures.
  • Trains and orients staff and care providers.
  • Oversees input of service and other documentation to the electronic records system.
  • Does related work as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES

Thorough knowledge of the theories, principles, practices and techniques related to the care and treatment of individuals with intellectual disabilities; thorough knowledge of the common disabilities of the individual population; thorough knowledge of service plan development, training and evaluation; thorough knowledge of human rights of residents; thorough knowledge of services and programs available to the residents within the agency and by external service providers; thorough knowledge of liability issues; considerable knowledge of case management principles and practices; considerable knowledge of the methods and use of electronic health records; considerable knowledge of the maintenance, security and safety practices and procedures related to the operation of a residential facility; considerable knowledge of state licensure requirements; some knowledge of business and human resource management principles and practices; ability to establish effective working relationships with a variety of others; ability to communicate effectively orally and in writing; ability to operate a vehicle; ability to collect and analyze data from a variety of sources including electronically and prepare recommendations, proposals, reports, etc.; ability to plan, train and supervise the work of others; ability to maintain effective working relationships.

TYPICAL EDUCATION, TRAINING AND WORK EXPERIENCE

Bachelor's Degree in the Behavioral Sciences, and considerable experience in residential treatment programs for intellectually disabled/developmentally disabled adults including some supervisory experience.

LICENSURE AND CERTIFICATIONS

Valid Virginia driver's license. Certification in First Aid/CPR. Training in Therapeutic Options (THEROPS) and Medication Management.

ENVIRONMENTAL AND PHYSICAL EXPOSURE

Work involves considerable exposure to disagreeable environmental conditions such as the requirements to interact with clients having poor hygiene and/or illness or are potentially hostile; drive a vehicle and transport clients in inclement, if not severe weather; regularly physically assisting and/or lifting clients in the course of care and lifting moderate weight objects in connection with the operation of the facility; is frequently interrupted during off-hours with stressful or emergent calls.

RELATIONSHIPS

Relationships require excellent communication and interpersonal skills to represent the program within the department and to community and state partners, organizations and agencies or other stakeholders concerning program initiatives and services and the ability to use appropriate techniques to counsel and manage the behaviors of program participants.

Job Type: Full-time

Benefits:

  • Employee assistance program
  • Flexible schedule
  • Paid time off
  • Professional development assistance
  • Referral program

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