Review Vacancy
TitleMedicaid Eligibility Examiner 1 (NY HELPS) - 79047, 79592
Occupational CategoryOther Professional Careers
Bargaining UnitASU - Administrative Services Unit (CSEA)
Salary RangeFrom $36232 to $52413 Annually
Street Address Office of Health Insurance Programs/ Division of Eligibility and Marketplace Integration/ Bureau of Program Review
99 Washington Avenue
Duties Description The Bureau of Program Review (BPR) monitors contractor, health plan and local district compliance with State and Federal eligibility rules and regulations.
The primary responsibilities of these MEE1/Trainee positions will include:
Conduct Child Health Plus (CHPlus) and Medicaid initial and peer post-eligibility reviews, designed to evaluate the appropriateness of recipient eligibility determinations and/or whether enrollment processes were properly executed.
Analyze data and/or conduct case-specific research to identify cases for possible follow-up action because they appear to be at risk for irregularities or vulnerabilities, as needed.
Conduct pre-review planning and preparation activities. Perform research and/or analysis in accordance with policies and procedures.
Perform post-review scanning activities. Assist others in accumulating review results and properly storing review files upon project completion.
Assist supervisors and managers in tallying and aggregating review results, as well as editing summary reports, when necessary.
Minimum Qualifications Permanent Transfer: Current NYS employee with one year or more of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner 1 (G9) OR a NYS employee with one year or more of permanent or contingent-permanent, competitive service in a position eligible for transfer under Section 70.1 of the Civil Service Law.
Non-Competitive Candidates via NY HELPS Program:
Medicaid Eligibility Examiner 1: Two years of experience determining or reviewing financial eligibility for healthcare or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations or performing quality assurance activities to ensure compliance with laws, rules, regulations, and policies in a health care delivery system including health care facilities; federal, State, or local health care agencies; hospitals; Medicaid programs; and/or other public or private health insurance programs.
30 semester credit hours can substitute for one year of experience.
Medicaid Eligibility Examiner Trainee 1: There are no minimum education or experience requirements. If you are appointed to a Trainee title, upon successful completion of a 12-month traineeship, you will automatically advance to the full journey level of the title, Grade 9.
Preferred Qualifications: Preferred candidates will have strong analytical skills and the ability to pay attention to details and will also have good oral and written communication skills. Candidates should have proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team and to manage multiple priorities to meet deadlines. Professional experience in public health insurance programs, including New York's Medicaid, Medicare and/or Child Health Plus and supervisory experience is a plus.
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: 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
Email Address resume@health.ny.gov
Address
Street Corning Tower, Empire State Plaza, Room 2217
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/MEE1/79047,79592 included in the subject line or by mail to Human Resources Management Group, SPD/MEE1/79047,79592, 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.