Review Vacancy
TitleHealth Program Administrator 2 - 87416
Occupational CategoryHealth Care, Human/Social Services
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $96336 to $121413 Annually
Street Address Office of Health Insurance Programs/Division of Program Development and Management/Bureau of Medical and Dental Policy
99 Washington Avenue
Duties Description The HPA2 will report to the HPA4 in the Bureau of Medical and Dental Policy. Duties include, but are not limited to:
Supervise the team handling inpatient and outpatient clinic facilities; This includes the following Medicaid policy areas: Inpatient, Outpatient, Clinic, Federally Qualified Health Centers, Ambulatory Payment Group, and Indian Health Services/Tribal Clinics.
Supervise the team handling laboratory and third-party health insurance policy. This includes coverage decisions on laboratory testing and review of laboratory enrollment applications.
Develop draft policies, regulations, or procedures to facilitate program implementation and operation. Review and develop recommendations regarding existing or proposed policy, rules, and regulations and draft proposed revisions.
Work with the program research and evaluation staff to develop program monitoring protocols. Summarize and present trends and performance metrics to program leadership.
Make recommendations to program policy and regulations to improve program quality and efficiency and to ensure that strategic objectives are achieved, based on review of performance metrics.
Compile and prepare reports at the request of the Executive, the State Legislature, or as required by external entities such as the Centers for Medicare and Medicaid Services.
Review audit responses and serve as liaison with oversight entities as appropriate.
Provide policy advice and expertise to the Division of Finance and Rate Setting and the Medicaid program actuaries on the anticipated fiscal impacts of policy changes.
Work with the Department’s contractor and OHIP rate setting staff on updates to the APG pricing logic and ensure that APG reimbursement is consistent with Medicaid payment policy.
Collaborate with other Divisions within OHIP to effectuate policy changes and priorities, including the Division of Eligibility and Marketplace Integration, the Division of Health Plan Contracting and Oversight and other areas of the Department of Health outside of OHIP and other state agencies.
Provide policy advice and expertise to the Division of Operations and Systems to ensure implementation of program changes in the appropriate Medicaid information systems, such as eMedNY, the Welfare Management System, and the Medicaid Data Warehouse.
Respond to routine and complex inquiries from Medicaid providers, develop and review training materials.
Supervise a staff of 5 to 8 individuals who will be responsible for developing, interpreting, and implementing Medicaid payment and coverage policy for a broad range of medical services reimbursed in both fee-for-service as well as Managed Care.
Supervise and direct staff on policy and coverage issues raised by the Office of the Medicaid Inspector General, the Office of the State Comptroller, and the Deputy Attorney General’s Medicaid Fraud Control Unit.
Minimum Qualifications Reassignment:
Current NYS DOH employee with a permanent of contingent-permanent, competitive status as a Health Program Administrator 2, G-25.
Transfer:
A NYS employee with one year or more of permanent or contingent-permanent, competitive service in a title at or above a G23 and deemed eligible for transfer to Health Program Administrator 2, G-25 under Section 70.1 or Section 52.6 of the NYS Civil Service Law.
The transfer cannot be a second consecutive transfer resulting in an advancement of more than two salary grades.
Preferred Qualifications: Extensive knowledge of NYS Medicaid or other public health programs and related policies including coverage, reimbursement, and claims processing, Knowledge of NYS Medicaid data systems, including eMedNY, Knowledge of federal and NYS Medicaid policy guidance and documents, Knowledge of NYS Medicaid Article 28 clinics and Ambulatory Patient Groups (APGs), Familiarity with Current Procedural Terminology (CPT) and HCPCS coding, Proficiency with Microsoft Excel and Word, and Supervisory experience.
Additional Comments 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 EM/87416/HPA2 included in the subject line or by mail to Human Resources Management Group, EM/87416/HPA2, 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.