Position Information

NY HELPSNo

55-b/c EligibleNo

AgencyHealth, Department of

TitleHealth Program Administrator 1 – 87212

Occupational CategoryAdministrative or General Management

Salary Grade23

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

Salary RangeFrom $90582 to $114585 Annually

Employment Type Full-Time

Appointment Type Permanent

InternshipNo

Jurisdictional Class Competitive Class

Travel Percentage 0%

Schedule

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 9 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

Location

County Albany

Street Address Office of Health Insurance Programs/ Division of Operations and Systems / Bureau of Provider Enrollment

11 Corporate Woods

City Albany

StateNY

Zip Code12211

Job Specifics

Duties Description The Bureau of Provider Enrollment (BPE) within the Division of Operations and Systems (DOS) in the Office of Health Insurance Programs (OHIP) is responsible for enrolling, maintaining, and revalidating more than 240,000 Medicaid providers (e.g., over 200,000 individual providers, more than 10,000 businesses, 11,000 practitioner groups, and 10,000 institutional providers). Proper enrollment is critical for providers to get reimbursed for essential care delivered to NYS Medicaid Members and to mitigate fraud, waste, and abuse within the Medicaid program. Core functions of the Bureau include all enrollment-related transactions, training and quality assurance, provider relationship management, program integrity, answering audits, and executing required data reporting. The Bureau partners with many different programs within OHIP, including but not limited to NYRx, dental, health access, maternal & child health, laboratory, and durable medical equipment policy teams. In addition BPE is the lead Bureau to Centers for Medicare and Medicaid Services (CMS) enrollment division, to NYS agencies including but not limited to Office for Alcohol and Substance Abuse Services (OASAS), Office of Mental Health (OMH), and Office for People with Developmental Disabilities (OPWDD). BPE also works together with the Office of the Medicaid Inspector General (OMIG) on fraud, waste, and abuse referrals as well as enrollment appeals and sanctions.

In 2025, BPE launched the first ever electronic Provider Services Portal (PSP) for enrollment, replacing a paper process. In April of 2026, CMS announced an initiative to revalidate all Medicaid providers within a two-year time period. The Bureau has developed a robust revalidation plan to accomplish the requirement.

The Health Program Administrator 1 (HPA1) primary responsibilities will include:

- Overseeing the day-to-day operations of an assigned provider enrollment production unit, including supervising staff, establishing priorities, assigning work, monitoring transaction aging and workloads, and supporting timely and accurate processing.

- Providing staff with guidance on provider enrollment policies, procedures, and operational requirements; monitoring performance; identifying training needs; and supporting quality assurance activities.

- Evaluating provider enrollment processes to identify bottlenecks, redundancies, operational gaps, and opportunities to improve efficiency, accuracy, and program administration.

- Analyzing enrollment data, workload statistics, and production metrics to identify trends and performance issues and provide data-informed recommendations to management.

- Developing and updating provider enrollment procedures, operational guidance, training materials, and quality assurance documentation to support program, system, and workflow changes.

- Serving as a provider enrollment program subject-matter expert and coordinating with internal systems staff, external technical staff, and vendors to communicate Medicaid program requirements and operational needs for the Provider Services Portal (PSP).

- Reviewing Functional Requirements Documents, Business Requirements Documents, Change Requests, System Change Requests, transmittals, and proposed system enhancements to ensure they accurately reflect provider enrollment policies and operational requirements.

- Participating in user acceptance testing, reviewing test results, identifying programmatic or operational concerns, and recommending corrective action prior to implementation.

- Maintaining knowledge of Medicaid provider enrollment requirements, operational processes, and supporting technologies to effectively coordinate program operations and system-related activities.

-Serving as a liaison with providers, vendors, systems staff, and other internal and external stakeholders regarding provider enrollment issues and cross-functional initiatives.

- Preparing clear and concise reports, correspondence, procedural guidance, provider communications, website content, and other written materials related to provider enrollment operations.

- Providing factual testimony on behalf of the Department of Health and the Bureau of Provider Enrollment in depositions, Grand Jury proceedings, trials, and other legal proceedings regarding provider enrollment records, procedures, transactions, and operations. Such proceedings may require travel, including travel to New York City.

- Participating in special projects and operational improvement initiatives that support bureau performance and effective administration of the Medicaid provider enrollment program.

Minimum Qualifications Permanent Transfer Candidates: Current New York State Department of Health employee with permanent or contingent permanent status as a Health Program Administrator 1, SG-23, OR; Current New York State employee with one year or more of permanent or contingent permanent service in a title eligible for transfer to Health Program Administrator 1, SG-23, under Section 52.6 or 70.1 of the Civil Service Law.

Preferred Qualifications: Excellent written and oral communication skills.
Experience with provider enrollment/credentialing process.
Experience with data collection and systems projects.
Experience working across technical and programmatic/policy stakeholders.

Additional Comments When reviewing qualifications, omissions and vagueness cannot be interpreted in the candidate’s favor. Candidates are responsible for providing accurate and clear descriptions of their experience demonstrating how they meet the minimum qualifications.

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.

The 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 of the position (beginning of the salary range). 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.

How to Apply

Name Human Resources Management Group, SPD/HPA1/87212

Telephone 518-486-1812

Fax 518-473-3395

Email Address resume@health.ny.gov

Address

Street Corning Tower, Empire State Plaza, Room 2217

City Albany

State NY

Zip Code 12237

 

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/HPA1/87212 included in the subject line or by mail to Human Resources Management Group, SPD/HPA1/87212, 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.