99 Washington Ave., One Commerce Plaza
Minimum Qualifications Current Department of Health (DOH) employee with permanent or contingent-permanent status as a Medical Assistance Specialist 3; OR current NYS employee with one year or more of permanent or contingent-permanent, competitive service in a title eligible to transfer under Section 52.6 or Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 3. For more information on the types of transfers, transfer eligibility criteria, and the current transfer determinations for your title, visit the following website.
Preferred Qualifications: https://careermobilityoffice.cs.ny.gov/cmo/gotit/index.cfm
Duties Description Within the Division of Eligibility and Marketplace Integration, Bureau of Program Compliance and Audit and Bureau of Program Review, the Medical Assistance Specialist 3 incumbents will manage staff in performing various types of program integrity and quality control functions for NYS' public health insurance programs to ensure eligibility and enrollment practices are performed in accordance with applicable federal and State laws, regulations, and policies; assist New York State with timely and efficient implementation of continuous coverage unwind operations; and provide ongoing support for the administration of New York’s health insurance programs.
Specific duties and responsibilities for this position may include but are not limited to:
• Provide first and second level supervision to professional subordinate staff, coordinate staff assignments, set unit priorities and deadlines, monitor, and evaluate staff performance, and resolve issues, as necessary.
• Act as a subject matter expert (SME) in workgroups established to query data systems to develop universes from which sample cases will be drawn. This includes overseeing the query testing process and collaborating with system staff to ensure correctness.
• Act as a SME in workgroups established to develop trainings and review protocols specific to each review project. This includes designing standardized review worksheets to ensure that reviews are complete and consistent.
• Oversee quality assurance and/or audit activities for staff and external parties as needed; participate in meetings to ensure consistent application of quality assurance and/or audit guidelines.
• Work with other Department agencies to obtain payment system information for sample cases and determine if the Federal Medical Assistance Percentage (FMAP) was correctly claimed.
• Review legislative proposals and regulatory amendments and determine their impact on operations; advises higher-level staff of impact on operations, and proposes changes based on program expertise.
• Prepare statistical and/or narrative reports summarizing case review results for management review and approval.
• Draft correspondence to, and liaise with CHPlus health plans, local districts and NY State of Health staff, and external auditors concerning their review results.
• As needed, provide technical assistance to program areas, NY State of Health staff, CHPlus health plans, local districts, and other State agencies. This includes directing root cause analyses and collaborating with program staff about policy decisions to resolve deficiencies and inconsistencies identified during the review process.
Additional Comments We offer a work-life balance and a generous benefits package, worth 65% of salary, including:
• Holiday & Paid Time Off
• Public Service Loan Forgiveness (PSLF)
• Pension from New York State Employees’ Retirement System
• Shift & Geographic pay differentials
• Affordable Health Care options
• Family dental and vision benefits at no additional cost
• NYS Deferred Compensation plan
• Access to NY 529 and NY ABLE College Savings Programs, and U.S. Savings Bonds
• And many more...
For new State employees appointed to graded positions, the annual salary is the hiring rate (beginning of the Salary Range) of the position. Promotion salaries are calculated by the NYS Office of the State Comptroller in accordance with NYS Civil Service Law, OSC Payroll rules and regulations and negotiated union contracts.
The NYS Department of Health is committed to making New York a safer, healthier, and more equitable place to live. Understanding health equity, social determinants of health and health disparities is critical to accomplish our goal of eliminating health disparities. 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.
Notes on ApplyingPlease submit your resume and cover letter as one (1) document, preferably in PDF format, by email to email@example.com, with Reference SD/MAS3/01410 included in the subject line or by mail to Human Resources Management Group, SD/MAS3/01410, 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.