StateJobsNY

NY HELPNo

AgencyHealth, Department of

TitleHealth Program Administrator 3 - 88506

Occupational CategoryHealth Care, Human/Social Services

Salary Grade27

Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)

Salary RangeFrom $95908 to $118129 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? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

County Albany

Street Address 431B Broadway

City Menands

StateNY

Zip Code12204

Minimum Qualifications Current NYS Department of Health employee with permanent or contingent-permanent, competitive status as a Health Program Administrator 3, G-27 OR a NYS employee with one year or more of permanent or contingent-permanent, competitive service in a title at or above a G-25 and deemed eligible for transfer under Section 70.1 or Section 52.6 of the NYS Civil Service Law.

Preferred Qualifications: Medicaid experience including an understanding of the eMedNY system; experience working with medical claims/prior approvals; policy development/implementation; excellent communication, written and organizational skills; ability to function independently and deal with multiple tasks and priorities

Duties Description The Health Program Administrator, G-27, will perform bureau management of day to day operations and logistics of the Prior Approval Unit and Claim Processing Unit in The Division of Operations and Systems’ Bureau of Medical Review. The bureau is responsible for review of prior authorization and prior approval requests for private duty nursing services, durable medical equipment, prosthetics, orthotics, medical supplies, hearing aids and out of state in patient placement (hospital and skilled nursing facilities) and review of claims for medical necessity and adherence to Department claims processing rules. Duties include providing administrative leadership for day to day operations; personnel management; administrative and facility management; fiscal management of bureau contracts and contractor quality assurance; problem resolution; data analysis of unit workload statistics and for potential fraud and abuse to be referred for investigation; policy expert for DME enrollment issue and participate in OMIG Medicaid Enrollment Appeals Committee as the DME expert; policy development for new technologies; manage staff responsible for review and updates to unit policies, procedure manuals. provider manuals, and fee schedules; provide policy guidance to OHIP’s Medicaid Managed Care, enrolled providers, manufacturers, and industry advocacy groups; and other duties assigned to support Bureau operations. Additional unit supervisory duties may be assigned based on the applicant’s experience and qualifications.

Some positions may require additional credentials or a background check to verify your identity.

Name Human Resources Management Group - JGL/HPA3/88506

Telephone 518-486-1812

Fax 518-473-3395

Email Address resume@health.ny.gov

Address

Street ESP - Corning Tower

Room 2217

City Albany

State NY

Zip Code 12237

Notes on ApplyingSubmit resume and cover letter, preferably in PDF format, to Human Resources Management Group, JGL/HPA3/88506, Room 2217, Corning Tower Building, Empire State Plaza, Albany, New York 12237- 0012, or fax to (518)473-3395, or by email to Resume@health.ny.gov, with Reference Code JGL/HPA3/88506 included in the subject line. Failure to include the required information in the subject line of your email or fax may result in your resume not being considered for this position. Resumes will be accepted until January 18, 2022.