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Review Vacancy

Date Posted 01/05/23

Applications Due02/14/23

Vacancy ID120910

AgencyHealth, Department of

TitleSenior Health Planner - 81015

Occupational CategoryOther Professional Careers

Salary Grade18

Bargaining UnitAPSU-Agency Police Services Unit (PBAofNYS)

Salary RangeFrom $61270 to $77912 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 9 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? Yes

Compressed workweek allowed? No

Telecommuting allowed? Yes

County Albany

Street Address Division of Health Plan Contracting and Oversight, Bureau of Fiscal Oversight

One Commerce Plaza

City Albany

StateNY

Zip Code12260

Minimum Qualifications Current Department of Health employee with permanent or contingent-permanent status as a Senior Health Planner OR current Department of Health or any NYS employee with one year of permanent or contingent-permanent service in a G-18 or higher title deemed eligible for transfer under Section 52.6 of the Civil Service Law.

Preferred Qualifications: Strong attention to details;
Experience in the field of Health Care Finances,
Strong analytical skills and written and verbal communication.

Duties Description This Senior Health Planner (SHP) G-18 will be responsible for daily activities ensuring Managed Care Organizations (MCOs) in New York State are compliant with State and Federal laws, regulations and policies related to health plan fiscal oversight. More specifically; the incumbent will be responsible for the review and analysis of Medicaid Managed Care Operating Reports (MMCORs)/cost reports for assigned MCOs that coordinate and integrate Medicare and Medicaid benefits for dual eligible enrollees. The SHP will work on evaluating and monitoring the financial condition of such assigned MCOs including preparing and analyzing reports, reviewing their operations for compliance with financial reporting, assuring adequate reserve and escrow fund requirements are met as required in State and Federal laws, regulations and policies. The SHP will be responsible for reviewing, commenting and approving the financial components of MCO provider and management contracts, intercompany, and administrative services agreements. The incumbent will be responsible for assisting in the review and evaluation of various transactions initiated by the assigned MCOs including but not limited to: Service Area Expansions, addition of new lines of business and mergers and acquisition. The SHP will also be responsible for review and evaluation of MCO equity transfer requests, extra-ordinary dividend requests, surplus notes and other asset transfer and capital contribution requests.

Additional Comments This work is critical to assure that the Medicaid Managed Care Organizations are solvent and in good financial standing to ensure compliance with Federal and State laws, NYS Regulations and fiscal policies, superficially supporting the development and expansion of integrated health plans arranging for the delivery of comprehensive healthcare for individuals eligible for both Medicare and Medicaid.

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/SHP/81015

Telephone 5184861812

Fax 518-473-3395

Email Address resume@health.ny.gov

Address

Street Room 2217, Corning Tower Building, Empire State Plaza

City Albany

State NY

Zip Code 12237

 

Notes on ApplyingPlease submit your resume and cover letter, preferably in PDF format, by email to resume@health.ny.gov, with Reference SD/SHP/81015 included in the subject line or by mail to Human Resources Management Group, SD/SHP/81015, 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.

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