Review Vacancy
TitleMedical Assistance Specialist 1 – 90408
Occupational CategoryOther Professional Careers
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $66951 to $85138 Annually
Appointment Type Contingent Permanent
Street Address Office of Health Insurance Programs/Division of Eligibility and Marketplace Integration / Bureau of Third Party Health Insurance, Medicare Savings Pro
99 Washington Avenue, One Commerce Plaza
Duties Description This Medical Assistance Specialist (MAS) 1 position will work within the Division of Eligibility and Marketplace Integration in the Bureau of Third Party Health Insurance, Medicare Savings Program and Recoveries (TPHI).
Duties will include, but not be limited to:
Work independently to review information submitted relative to Third Party Health Insurance (TPHI) and make the necessary determination regarding when and how to update associated systems.
Take the appropriate actions with regard to Medicaid enrollment and premium reimbursement.
Demonstrate MAXe tasks for new employees and review their task progress.
Perform review of premium payments and authorize payments.
Review and update records based on reports relative to MSP, TPHI, Potential TPHI, BML inquiries, Managed Care lists and TPL Suppression Reports
Problem solve complex cases.
Identify potential risk in the TPL premium payment process.
Track, update and create reports from departmental data.
Create and maintain Recovery specific spreadsheets and procedural documents used for tracking and pursuing voluntary overpayments.
Answer calls from Medicaid recipients with questions about their premium reimbursement checks or recoveries.
Calculate monthly unit statistics and provide them to TPL Operations staff for inclusion on monthly TPL production reports.
Run simple MDW queries to assist with TPL data needs.
Review HIPP reports to identify anomalies and report possible system defects to TPL management.
Oversee the work of subordinate staff and assist with work-related questions or issues.
Review and apply Medicaid policy and identify issues with process where adherence to policy may need review.
Document and assist with review of procedures and answer questions for subordinates, management, or other stakeholders regarding applying policy to TPL processes.
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 strong analytical skills and the ability to pay attention to details and will also have good oral and written communication skills. Candidates should have proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team and to manage multiple priorities to meet deadlines. Professional experience in public health insurance programs, including New York's Medicaid, Medicare and/or Child Health Plus and supervisory experience is a plus.
Additional Comments 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.
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 Resources 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 SPD/MAS 1/90408 included in the subject line or by mail to Human Resources Management Group, SPD/MAS 1/90408, 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.