StateJobsNY

NY HELPNo

AgencyHealth, Department of

TitleHealth Care Surveyor 2 (nursing) - 90715

Occupational CategoryHealth Care, Human/Social Services

Salary Grade19

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

Salary RangeFrom $64589 to $82036 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? Yes

Telecommuting allowed? Yes

County Albany

Street Address Division of Operations & Systems

431B Broadway

City Albany

StateNY

Zip Code12204

Minimum Qualifications Current Department of Health employee with permanent or contingent permanent status as a Health Care Surveyor 2 (Nursing), SG-19.

OR you must be licensed and currently registered to practice nursing in New York State AND have three years of post-licensure professional nursing experience, at least two of which must have been professional clinical nursing experience in a licensed health care facility and take a NYS examination using the link provided at: https://www.cs.ny.gov/announarchive/announcements/20-911.cfm

For the purpose of this examination, qualifying health facilities and programs include hospitals, nursing homes, adult homes, ambulatory care facilities, managed care organizations, psychiatric centers, diagnostic and treatment clinics, home health agencies, assisted living facilities, hospice, renal dialysis units, alcoholism and substance abuse treatment facilities, developmental centers and community-based programs for the mentally ill and developmentally disabled. Experience as an RN in a private doctor's office or group practice, or as a school nurse is NOT considered qualifying for the purpose of this examination.

Substitution: A bachelor's or master's degree in Nursing can be substituted for the one year of required general nursing experience.

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 Care Surveyor 2 (HCS2), grade 19, will be assigned to the Medical Prior Approval Unit, responsible for review of prior authorization and prior approval of nursing services, durable medical equipment, prosthetics, orthotics, medical supplies, hearing aids and out of state in patient placement (hospital and skilled nursing facilities). The staff person will perform prior approval review functions to determine if services requested are medically necessary, fall within the scope of coverage of the Medicaid program, and if the service is appropriate for the member’s medical needs. This function requires the use of professional medical judgment in the examination of submitted prior approval requests, paid claims history, and provider submitted documentation to substantiate the medical necessity for the requested services. The position involves utilizing national standards for procedure and diagnosis coding, reviewing appropriate combinations of medical services, and identifying methods to prevent fraud and abuse. This position is required to maintain adequate staffing so that the Unit can continue to meet review timeframes specified in regulation (reviews competed within 21 days).

Additional Comments Benefits of Working for NYS
Generous benefits package, worth 65% of salary, including:

Holiday & Paid Time Off
- Thirteen (13) paid holidays annually
- Up to Thirteen (13) days of paid vacation leave annually
- Up to Five (5) days of paid personal leave annually
- Up to Thirteen (13) days of paid sick leave annually for PEF/CSEA
- Up to Eight (8) days of paid sick leave annually for M/C
- Up to three (3) days of professional leave annually to participate in professional development

Health Care Benefits
- Eligible employees and dependents can pick from a variety of affordable health insurance programs
- Family dental and vision benefits at no additional cost

Additional Benefits
- NYS Employees’ Retirement System (ERS) Membership
- NYS Deferred Compensation
- Access to NY 529 and NY ABLE College Savings Programs, as well as U.S. Savings Bonds
- Public Service Loan Forgiveness (PSLF)
- And many more.

This position requires proof of vaccination from COVID-19

Frequent travel, including overnights and travel to areas that may not be served by public transportation is required. Please submit the NYS Application for examinations along with your resume. https://www.cs.ny.gov/extdocs/pdf/nysapp.pdf

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

Name Human Resources Management Group; SD/HCS2/90715

Telephone 518-473-8953

Fax 518-473-3395

Email Address resume@health.ny.gov

Address

Street Rm 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/HCS2/90715 included in the subject line or by mail to Human Resources Management Group, SD/HCS2/90715, 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.