Review Vacancy
AgencyMental Health, Office of
TitleResources and Reimbursement Agent 1/Resources and Reimbursement Agent Trainee 1, Central Office;
Occupational CategoryFinancial, Accounting, Auditing
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $52293 to $66494 Annually
Appointment Type Contingent Permanent
Minimum Qualifications Please Note: You must be a current employee of New York State to be eligible to apply for this position.
Candidates must currently be permanent in this title and eligible for a lateral transfer, OR have one year of permanent service in a title eligible for transfer under Section 70.1 of the Civil Service Law. If you are unsure as to whether you qualify for transfer, you may request a determination at OMHHRM@OMH.NY.GOV
Duties Description The Office of Mental Health (OMH) is seeking a qualified candidate to fill a Resources & Reimbursement Agent 1/Resources & Reimbursement Agent Trainee position for the Office of Financial Management, State Operations Finance Group, Managed Care and Contracting unit. This unit handles policy issues impacting OMH and the State Operations Finance Group including managed care contracting and related policy issues such as Mainstream Managed Care (MMC) programs, Health and Recovery Programs (HARP) and Home and Community Based Services (HCBS). The team also handles contracting and policy management related to pharmacy reimbursement programs and billing management including clearinghouse contracts.
The incumbent will perform specialized activities related to Medicaid Managed Care plans, Medicare Advantage plans, commercial managed care plans, and specialized managed care plans such as Tricare, Fully Integrated Dual Advantage plans, and Developmental disabilities Individual Support and Care Coordination plans. Specific duties include, but are not limited to, the following:
• Initiating and negotiating managed care contracts.
• Coordinating managed care contracting requirements with the Office of Information Technology Systems for inpatient and outpatient billing systems.
• Coordinating managed care contracting requirements with Patient Resource Office managers.
• Ongoing contract management.
• Managing the clearinghouse contract and functions.
Some positions may require additional credentials or a background check to verify your identity.