Job Description

The duties that the incumbent of the vacancy will be expected to perform. Duties Description This Medical Assistance Specialist 2 (MAS 2) will work within the Division of Eligibility and Marketplace Integration (DEMI), Bureau of Downstate Eligibility Systems. Candidate would be responsible for the following: Evaluate the operations of public health insurance programs, and where appropriate, recommend modifications to automated and manual processes, make recommendations to update the design and provide input on enhancements to eligibility systems.Identify and resolve critical errors of newly developed software for Medicaid automated systems.Review, analyze and interpret eligibility data for Medicaid or other Public Health Insurance Programs to support the development of requirements. Provide directions to technical staff in the development of automated systems.Proficiently utilize all automated Systems pertaining to health insurance programs including NYSOH, WMS and eMedNY.Provide technical assistance to local districts, State agencies and other stakeholders to ensure compliance with State and Federal regulations.Conduct Root Cause analysis and Joint Application Development (JAD) sessions with business users to obtain required information.Develop functional specifications to integrate with State systems (eMEDNY, WMS, EDITS, POS).Develop and review training materials for Statewide Program initiatives. Supervise and assign work to subordinates and review all correspondence and reports completeness and appropriateness.

The minimum qualifications required for this vacancy. Minimum Qualifications COMPETITIVE MINIMUM QUALIFICATIONS: Reassignment: Current Department of Health (DOH) employee with permanent or contingent-permanent status as a Medical Assistance Specialist 2. 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 2.NON-COMPETITIVE MINIMUM QUALIFICATIONS: Seven years of professional experience performing one or more of the following activities in a health care facility, health care agency, health care delivery system, Medicaid program, and/or other public or private health insurance program: establishing, revising, and/or assisting with the implementation of program policies and procedures to meet treatment and/or regulatory requirements of health care; analyzing State and/or federal health insurance laws to inform the development or modification of program operations; determining financial eligibility for enrollment in public or private health insurance plans or government funded health services programs; 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; conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations. An associate degree may substitute for up to two years of the experience; bachelor’s degree may substitute for up to four years. Preferred Qualifications: Preferred candidates will have experience in public health insurance programs, including New York’s Medicaid and/or Child Health Plus, and with data systems including, but not limited to, the Welfare Management System (WMS), NY State of Health Back Office and eMedNY. In addition, preferred candidates will have the ability to research and analyze information; demonstrated experience in requirements gathering and analysis of policy guidance; strong written and verbal communication skills; excellent interpersonal and organizational skills; and the ability to work well under pressure and adapt to changing priorities and tight timeframes. Supervisory experience is a plus.

Additional comments regarding the vacancy. 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: 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.

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Job Tags

Permanent employment, Work at office, Local area, Visa sponsorship, Shift work

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