Review Vacancy
TitleProgram Research Specialist 2 HCF - 87324
Occupational CategoryOther Professional Careers
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $79325 to $100342 Annually
Street Address OHIP, Division of Health Plan Contracting and Oversight, Bureau of Fiscal Oversight
One Commerce Plaza
Minimum Qualifications Current DOH or New York State employee with one year of permanent or contingent-permanent service as a Program Research Specialist 2 (HCF).
Preferred Qualifications: Strong attention to details;
Experince in the field of Health Care Fiances,
Strong written and verbal communication, interpersonal and analytical skills.
Duties Description The Program Research Specialist 2 (PRS 2) G-23 will play a vital function as a liaison between the Department and assigned plans among the Medicaid Managed Care, HARP and HIV SNP lines of business, as well as perform Managed Care Organization (MCO) for fiscal compliance with State and Federal regulatory requirements. Primary responsibilities of the positions include:
• Monitoring the financial condition of assigned managed care plans, including analysis of their financial operations and compliance with financial reporting such as the NYS Escrow Fund, Contingent Reserve and Net Worth requirements for compliance with Public Health Law, regulations, and policies.
• Evaluating management service contracts between managed care plans and contracted vendors for compliance with fiscal solvency requirements.
• Evaluating provider contracts including VBP contracts between managed care plans and providers for risk assessment in accordance with fiscal solvency requirements, DOH guidelines and regulations.
• Review and evaluate managed care plan expansions, mergers and acquisitions.
• Review and evaluate equity transfers, such as dividend requests, asset transfers and surplus note repayments, and assure overall plan compliance with the financial and solvency rules, regulations and contract provisions.
Additional Comments For more information on the NYS Department of Health’s Mission, Vision, Values and Strategic Plan, please visit: https://health.ny.gov/commissioner/index.htm
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resources Management Group, SD/PRS2HCF/87324
Email Address resume@health.ny.gov
Address
Street Room 2217, Corning Tower Building, Empire State Plaza
Notes on ApplyingPlease submit your resume and cover letter, preferably in PDF format, by email to resume@health.ny.gov, with Reference SD/PRS2HCF/87324 included in the subject line or by mail to Human Resources Management Group, SD/PRS2HCF/87324, Rm 2217, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0012, or by fax to (518) 473-3395. Failure to include the required information may result in your resume not being considered for this position.