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Review Vacancy

Date Posted 08/23/19

Applications Due09/06/19

Vacancy ID73340

AgencyHealth, Department of

TitleHealth Program Administrator 3 – item 90612

Occupational CategoryOther Professional Careers

Salary Grade27

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

Salary RangeFrom $90375 to $111316 Annually

Employment Type Full-Time

Appointment Type Contingent Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8:30 AM

To 4:30 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? No

County Albany

Street Address Office of Health Insurance Programs, Division of Operations and Systems, Bureau of Medical Review

431 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: Knowledge of Medicaid regulations, rules and payment policies with extensive experience in prior approval or medical claims adjudication.

Duties Description This position will be responsible for management of day to day operations and logistics of the Prior Approval Unit in the Division of Operations and Systems’ Bureau of Medical Review. The Bureau of Medical Review performs prior authorization and prior approval requests for private duty nursing services, durable medical equipment, prosthetics, orthotics, medical supplies, hearing aids, and out of state patient placement (hospital and skilled nursing facilities). Duties include: provide administrative leadership for day to day operations; personnel and administrative management; contractor quality assurance; problem resolution; data analysis of unit workload statistics for potential fraud and abuse to be referred for investigation; policy development for new technologies and evaluation of current policies for appropriateness with current medical practices and guidelines; manage staff responsible for review and updates to unit procedure manuals, provider manuals, and fee schedules; provide policy guidance to OHIP’s Medicaid Managed Care, enrolled providers, manufacturers and industry advocacy groups; assist in development of procurement documents for future contracts; make changes to unit policy as necessary from hearing decisions rendered, and other duties assigned to support Bureau operations. Additional unit supervisory duties may be assigned based on the applicant’s experience and qualifications.

Additional Comments Contingent-Permanent, full-time, competitive appointment.

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

Name Human Resources Management Group - ST/HPA3/90612,

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 to Human Resources Management Group, ST/HPA3/90612, 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 ST/HPA3/90612 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 September 6, 2019

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