Review Vacancy
TitleMedical Assistance Specialist 1 (NY HELPS) - 81013, 79967
Occupational CategoryOther Professional Careers
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $66951 to $85138 Annually
Appointment Type Contingent Permanent
Street Address Division of Eligibility and Marketplace Integration / Bureau of Program Compliance and Audit
99 Washington Avenue, One Commerce Plaza
Duties Description The MAS1 incumbent will supervise a team of subordinate staff in the Bureau of Program Compliance and Audit (BPCA) within the Division of Eligibility and Marketplace Integration (DEMI) and will assist higher level staff with primary BPCA functions. Duties may include, but not be limited to:
Monitoring the status of all audits and reviews involving DEMI program areas, including ones conducted by the Office of State Comptroller (OSC), the Office of the Inspector General (OIG) and the federally mandated Payment Error Rate Measurement (PERM) audit.
Liaising with appropriate State and Federal contacts to ensure adequate DEMI attendance at all audit related meetings/conferences. Coordinating DEMI responses to preliminary, draft, and final findings/reports, follow-up questions, and requests for status updates.
Reviewing eligibility findings involving NY State of Health (NYSOH) to determine if DEMI agrees with audit conclusions. Coordinating with appropriate program staff to ensure that all other cases are reviewed and evaluated in a consistent manner. Reviews will include ensuring financial eligibility criteria was met when reviewing eligibility determinations for NYSOH programs and performing quality assurance activities of eligibility determinations to ensure compliance with laws, rules, regulations, and policies.
Assist with supervising and coordinating logistics for onsite fieldwork, as needed. This may include: systems access, trainings and work space.
Providing direct and indirect supervision of subordinate staff, including determining criteria for unit performance, training, performance evaluations and counseling.
Minimum Qualifications Reassignment: Current NYS Department of Health (DOH) employee with permanent or contingent-permanent status as a Medical Assistance Specialist 1, G-18.
Transfer: 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 1, G-18.
NY HELPS: Six years of experience developing public or private health related policy; analyzing AND interpreting public or private health related policy to assist consumers; determining or reviewing financial eligibility for healthcare or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations; establishing mechanisms for the reimbursement and financing of health care services, including rate-setting, development of capitation reimbursement methodologies, and development of fee schedules; performing utilization review of requests for medical treatment including prior approval or authorization activities, adjudication of claims for payment and/or provider credentialing; AND/OR conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.
Substitution: An associate degree can substitute for two years of specialized experience; a bachelor’s degree can substitute for four years of experience; a master’s degree in a related field can substitute for five years of experience; and a doctorate in a related field can substitute for six years of experience.
Preferred Qualifications: Preferred candidates will have professional experience in public health insurance programs, including New York’s Medicaid and/or Medicare. 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.
Additional Comments This position is part of the NYS HELPS program. No examination is required.
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.
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 (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.
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resource Management Group
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 WDW/MAS1/81013,79967 included in the subject line or by mail to Human Resources Management Group, WDW/MAS1/81013,79967, 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.