Division of Eligibility and Marketplace Integration
Minimum Qualifications "Permanent: Current NYS employee with one year or more of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner 2 (G14), OR a NYS employee with one year or more of permanent or contingent-permanent, competitive service in a position allocated to a salary grade 12 or above and eligible for transfer under Section 70.1 of the Civil Service Law.
Provisional: Current Department of Health employee with one year of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner 1 or Medicaid Eligibility Examiner 1 (Spanish Language).""
Candidates appointed provisionally will be required to take and pass the next scheduled Civil Service examination for this title, when it is given, and be immediately appointable from the resulting eligible list to maintain employment.
Preferred Qualifications: Preferred candidates will have professional experience in public health insurance programs, including New York’s Medicaid, Medicare and/or Child Health Plus. Preferred candidates will also have excellent verbal and written communication skills; strong analytical skills and attention to detail; strong organizational skills; proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team, and to manage multiple priorities in order to meet deadlines; and experience using electronic data systems, such as eMedNY and NYSOH Back Office. Supervisory experience is a plus.
Duties Description "The Division of Eligibility and Marketplace Integration (DEMI) is recruting to fill multiple Medicaid Eligibility Examiner 2 (MEE 2) positions in many of its bureaus, including: Bureau of Third Party Health Insurance, Medicare Savings Program and Recoveries; Bureau of Community Enrollment and Eligibility Processing; Bureau of Program Review; Bureau of External Audit; Bureau of Exchange Application Support; Bureau of Consumer Relations & Local District Support, and Upstate Eligibility Systems; Bureau of Long Term Care/SSI Related Populations; and Bureau of Child Health Plus and Marketplace Consumer Assistance. Duties may include, but are not limited to:
• Receive and review applications and renewals for Medicaid and other public health insurance programs within DOH. Determine eligibility by analyzing and applying applicable laws, rules, and regulations. Research application status and prior history using applicable computer systems.
• Collect appropriate documentation to support and maintain eligibility status of applicants.
• Provide information on public health insurance eligibility to consumers, local social service agencies, health insurance carriers, and other agencies.
• Review information and questions received via mail, email, or phone. Respond to inquiries and troubleshoot complex case issues.
• Review receipts submitted by enrollees to determine eligibility for reimbursement of paid medical expenses covered by the Medicaid program.
• Review accounts to ensure that eligibility was determined correctly.
• Review various reports to identify anomalies and report possible system defects to Bureau management.
• Identify potential risk in program processes.
• Assist with computer application and system testing.
• Update various tracking spreadsheets, reports, procedural documents and records.
• Prepare client notices and repayment agreements.
• Review, compile and organize data for various reports.
• Create customized Access database queries and reports to support contract managers. Produce and send customized reports and other communications to various stakeholders.
• Conduct quality assurance activities.
• Participate in the post-eligibility review process to verify whether policies and procedures were correctly followed by various entities when recipients were approved for public health insurance coverage.
• Supervise subordinate staff. Plan and conduct staff training.
Additional Comments If three or fewer New York State Department of Health promotional candidates respond to this notice, the agency may, at its discretion, nominate a qualified employee for non-competitive promotion under the provisions of Section 52.7 of the Civil Service Law. Employees must have one year of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner 1 or Medicaid Eligibility Examiner 1 (Spanish Language). If certified by Civil Service, mandatory reemployment list candidates must be considered first for appointment to this title.
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.
Empire State Plaza
Notes on ApplyingPlease submit your resume and cover letter, preferably in PDF format, by email to firstname.lastname@example.org, with Reference SD/MEE2/DEMI included in the subject line or by mail to Human Resources Management Group, SD/MEE2/DEMI, 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.