Review Vacancy
TitleMedicaid Eligibility Examiner 4 - 15330
Occupational CategoryOther Professional Careers
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $75850 to $96173 Annually
Street Address Division of Eligibility and Marketplace Integration/Bureau of Third Party Health Insurance, Medicare Savings Program and Recoveries
One Commerce Plaza
Minimum Qualifications Permanent Transfer: Current New York State Department of Health employee with permanent or contingent-permanent status as a Medicaid Eligibility Examiner 4, Grade 21.
Preferred Qualifications: Preferred candidates will have professional experience in public health insurance programs, including New York’s Medicaid, Medicare and/or Child Health Plus. Preferred candidates will also have excellent verbal and written communication skills; strong analytical skills and attention to detail; strong organizational skills; proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team, and to manage multiple priorities in order to meet deadlines; and experience using electronic data systems, such as eMedNY and NYSOH Back Office. Supervisory experience is a plus.
Duties Description The Medicaid Eligibility Examiner 4 (MEE 4) will work within the Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries. Duties will include:
Work independently to review information submitted relative to Third Party Health Insurance (TPHI) and make the necessary determinations regarding when and how to update eMedNY.
Provide first and second level supervision to subordinate staff. Train and mentor employees and review task progress. Manage assigned processes within the unit to ensure adherence to policy, performance levels, and applicable turnaround times.
Take the appropriate actions regarding Medicaid enrollment and premium reimbursement.
Review reports related to TPHI, BML inquiries, Managed Care lists, TPL Suppression Reports and other Third-Party reports to create, modify, track and evaluate processes, identify anomalies and report possible system defects to TPL management.
Resolve complex case issues and refer to other program area staff as appropriate.
Identify potential risk in the TPL premium payment process.
Calculate monthly recovery statistics and provide them to TPL Operations staff for inclusion on monthly TPL production reports.
Maintain Recovery specific spreadsheets and databases used for identifying and tracking potential HIPP and MIPP overpayments.
Additional Comments 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.
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
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resources Management Group, EW/MEE4/15330
Email Address Resume@health.ny.gov
Address
Street Room 2217, Corning Tower
Empire State Plaza
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 EW/MEE4/15330 included in the subject line or by mail to Human Resources Management Group, EW/MEE4/15330, 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.