Review Vacancy
TitleHealth Systems Specialist 4
Occupational CategoryNo Preference
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $75243 to $94834 Annually
Street Address Office of Health Insurance Programs, Division of Health Plan Contracting and Oversight, Bureau of Managed Care Certification and Surveillance
Corning Tower, Empire State Plaza
Minimum Qualifications Current Department of Health or NYS employee with one year of permanent or contingent-permanent service in a G-23 or higher title, deemed eligible for transfer under Section 70.1 of NYS Civil Service Law.
PREFERRED QUALIFICATIONS:
Experience with overseeing managed care organizations for compliance with Public Health Law Articles 44 and 49 and regulations. Familiarity with the Medicaid managed care and Child Health Plus programs and the Medicaid Redesign Team initiatives.
Duties Description Supervision of project managers in their day to day activities related to the certification of health maintenance organizations and registration of utilization review agents. The incumbent will: develop and recommend legislation, regulations and policy affecting the managed care industry; recommend/direct statements of deficiencies/enforcement actions against managed care plans in response to issues identified from onsite and targeted surveillance and non-compliance with routine MCO reporting requirements; approve utilization review agent applications; direct MCOs on the coordination/development and implementation of plan in response to unexpected events such as natural disasters, states of emergency, hospital closures etc.; develop and update policies and procedures for the various transactions occurring in the managed care industry such as MCO market withdrawals, mergers and acquisitions as examples.
Additional Comments Permanent, full-time.
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resources Management Group, SC/87416/HSS4
Email Address resume@health.state.ny.us
Address
Street Room 2217, Corning Tower Building
Empire State Plaza
Notes on ApplyingIf you are a current New York State employee: submit resume to Human Resources Management Group, SC/87416/HSS4, Room 2217, Corning Tower Building, Empire State Plaza, Albany, New York 12237- 0012, or by email to resume@health.state.ny.us with a subject line SC/87416/HSS4, or by fax to (518) 473-3395 with a subject line SC/87416/HSS4. Applications will be accepted until the position is filled.