Review Vacancy
TitleProgram Research Specialist 2 Health Care Finance (HCF) (NY HELPS) - 87311
Occupational CategoryOther Professional Careers
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $86681 to $109650 Annually
Street Address Division of Finance and Rate Setting/ Bureau of Managed Long Term Care Rate Setting
99 Washington Avenue
Duties Description The Program Research Specialist 2 will work in the Office of Health Insurance Programs, Division of Finance and Rate Setting. This position will perform research, evaluation, and analytical studies relating to the fiscal oversight of the Partial Capitation, Medicaid Advantage Plus (MAP) and Program of All-inclusive Care for the Elderly (PACE) Managed Long Term Care Programs.
Tasks will include performing review of capitation rate setting calculations, quality pool awards, directed payments and payment reconciliations. Funding methodologies will be developed, implemented and reviewed that incorporate specified quality metrics, fee-for-service rate schedules, health plan encounter data and community health assessment data as well as plan cost report and data surveys.
Further, the incumbent will analyze and interpret Medical Loss Ratios and Profit and Loss status of health plans and recommend methods to address health plan solvency issues. The incumbent will support data analytical landscape transitions and adoption and use of new visual analytics software programs to accurately and efficiently analyze, review, and present healthcare program and financing data to support healthcare program and policy decisions. Duties include data management and analytics responsibilities including advanced data extraction from various data sources including but not limited to the Medicaid Data Warehouse (MDW), OHIP Datamart, and Plan Cost Reports. The incumbent will support Managed Care rate setting by assisting in review of calculations used in rate package and premium rate development components, fiscal impact calculations, and accurate documentation preparation for review and approval by the Division of Budge and the Centers for Medicare and Medicaid Services (CMS). The incumbent will conduct and oversee Quality Assurance checks through periodic rate audits, participate in enahnced Federal Medical Assistance Percentage (eFMAP) programs and calculations including the CFCO program. Ad-hoc program and financial inquiries will be thoroughly conducted through advanced data extraction, manipulation, review, analysis, and summarization to support data-driven decision making within the Department.
Minimum Qualifications Current New York State Department of Health employee with permanent or contingent permanent status as a Program Research Specialist 2 Health Care Finance (HCF), SG-23, OR; Current New York State employee with one year or more of permanent or contingent-permanent, competitive service in a title at or above SG-21, and eligible to transfer under Section 52.6 of the Civil Service Law to Program Research Specialist 2 Health Care Finance (HCF), SG-23.
Non-Competitive Candidates via NY HELPS Program: A bachelor's degree including or supplemented by NINE semester credit hours in statistics, biostatistics, economics, econometrics, research methods, mathematics, data analysis, or data modeling PLUS THREE YEARS of professional* research experience in the collection and evaluation of quantitative data directed toward review and analysis of healthcare reimbursement mechanisms, funding methodology, health economics, healthcare financing, cost containment, or patient classification systems.
Substitution: J.D. or master's degree may substitute for one year of the experience; a doctoral degree may substitute for two years of the experience.
Preferred Qualifications: Experience with data analysis, research and evaluation in healthcare financing and reimbursement is preferred.
Additional Comments When reviewing qualifications, omissions and vagueness cannot be interpreted in the candidate’s favor. Candidates are responsible for providing accurate and clear descriptions of their experience demonstrating how they meet the minimum qualifications.
This position is part of the NYS HELPS program. No examination is required.
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...
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
If you require reasonable accommodation to complete a job application, a job interview or to otherwise participate in the hiring process, please contact by phone 518-486-1812 or email doh.sm.Reasonable.Accommodation@health.ny.gov to make a request.
The NYS Department of Health does not participate in E-Verify and does not sponsor visa applications.
For new State employees appointed to graded positions, the annual salary is the hiring rate of the position (beginning of the salary range). 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.
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resources Management Group. CD/PRSHCF2/87311
Email Address resume@health.ny.gov
Address
Street Corning Tower, Empire State Plaza, Room 2217
Notes on ApplyingPlease submit your resume and cover letter as one (1) document, preferably in PDF format, by email to resume@health.ny.gov, with Reference CD/PRSHCF2/87311 included in the subject line or by mail to Human Resources Management Group, CD/PRSHFC2/87311, 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.