NY HELPNo

AgencyHealth, Department of

TitleHealth Program Administrator 3 - 88506

Occupational CategoryHealth Care, Human/Social Services

Salary Grade27

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

Salary RangeFrom $106989 to $131665 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Competitive Class

Travel Percentage 5%

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? No

County Albany

Street Address OHIP/Division of Medical and Dental Directors/Bureau of Medical Review

99 Washington Ave

City Albany

StateNY

Zip Code12210

Duties Description The Health Program Administrator 3 (HPA 3), Grade 27, will manage and provide oversight to the Claims Review Program within the Bureau of Medical Review (BMR) for the Office of Health Insurance Programs (OHIP), Division of Medical and Dental Directors. The Claims Review Program is responsible for the review of Medicaid fee-for-service claims for medical necessity, timeliness and adherence to Department claims processing rules. Units within the program include Pended Claims, Provider on Review (01142), Center of Operational Excellence (COE), and High-Cost Outlier (HCO). The incumbent will supervise unit managers and provide second-level supervision to supervisors and front-line staff. Responsibilities include providing leadership for day-to-day operations; overseeing personnel and administrative functions; managing bureau contracts and contractor quality assurance; resolving complex operational issues; and analyzing workload and performance data to support resource allocation and identify potential fraud and abuse for referral and investigation. Additional duties include overseeing staff responsible for the development, review, and maintenance of unit policies and procedures; providing policy guidance to OHIP’s Medicaid Managed Care Organizations, enrolled providers, manufacturers, and industry advocacy groups; and performing other duties as assigned in support of Bureau operations. Additional supervisory duties may be assigned based on the applicant’s experience and qualifications.

Minimum Qualifications Permanent Transfer Candidates: Current NYS Department of Health employee with one year of permanent or contingent-permanent, competitive, service as a Health Program Administrator 3, SG-27, and eligible to transfer under Section 70.1 or Section 52.6 of the NYS Civil Service Law OR Current NYS employee with one year of permanent or contingent-permanent, competitive, service in a title SG-25 or higher and eligible to transfer under Section 70.1 or Section 52.6 of the NYS Civil Service Law.

Preferred Qualifications: Knowledge of Microsoft Office Suite, Medicaid Program and/or eMeNY system preferred.

Additional Comments Telecommuting option will be discussed at the interview.

This position may require travel throughout New York State including overnights to areas not served by public transportation.

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.

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.

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

Name Human Resources Management Group

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 ApplyingPlease submit your resume and cover letter as one (1) document, preferably in PDF format, by email to resume@health.ny.gov, with Reference CD/HPA3/88506 included in the subject line or by mail to Human Resources Management Group, CD/HPA3/88506, 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.