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Review Vacancy

Date Posted 06/01/18

Applications Due06/15/18

Vacancy ID53849

AgencyHealth, Department of

TitleHealth Program Administrator 3 – 90612

Occupational CategoryOther Professional Careers

Salary Grade27

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

Salary RangeFrom $90375 to $111316 Annually

Employment Type Full-Time

Appointment Type Contingent Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8:30 AM

To 4:30 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? No

County Albany

Street Address OHIP, Division of Operations and Systems, Bureau of Medical Review

431B Broadway

City Menands

StateNY

Zip Code12204

Minimum Qualifications Current Department of Health employee with permanent or contingent-permanent status as a Health Program Administrator 3 OR NYS employee with one year of permanent or contingent-permanent service in a title at G-25 or above that is eligible for transfer under Section 52.6 or 70.1 of the Civil Service Law.

PREFERRED
QUALIFICATIONS
Knowledge of Medicaid regulations, rules and payment policies with extensive experience in prior approval or medical claims adjudication.

Duties Description This position will be responsible for management of day to day operations and logistics of the Prior Approval Unit in the Division of Operations and Systems’ Bureau of Medical Review. The Bureau of Medical Review performs prior authorization and prior approval requests for private duty nursing services, durable medical equipment, prosthetics, orthotics, medical supplies, hearing aids, and out of state inpatient placement (hospital and skilled nursing facilities). Duties include providing administrative leadership for day to day operations; personnel management; administrative and facility management; fiscal management of bureau contracts and contractor quality assurance; problem resolution; data analysis of unit workload statistics and for potential fraud and abuse to be referred for investigation; policy development for new technologies and evaluation of current policies for appropriateness with current medical practices and guidelines; manage staff responsible for review and updates to unit procedure manuals, provider manuals, and fee schedules; provide policy guidance to OHIP’s Medicaid Managed Care, enrolled providers, manufacturers and industry advocacy groups; and assist in development of procurement documents for future contracts; make changes to unit policy as necessary from hearing decisions rendered, and other duties assigned to support Bureau operations. Additional unit supervisory duties may be assigned based on the applicant’s experience and qualifications.

Additional Comments Contingent-Permanent, full-time appointment.

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

Name Human Resources Management Group, SP/HPA3/90612

Telephone (518) 486-1812

Fax (518) 473- 3395

Email Address resume@health.ny.gov

Address

Street Room 2217, Corning Tower Building, Empire State Plaza,

City Albany

State NY

Zip Code 12237

 

Notes on ApplyingSubmit resume, preferably in PDF format, to Human Resources Management Group, SP/HPA3/90612, Room 2217, Corning Tower Building, Empire State Plaza, Albany, New York 12237-0012, or by email to resume@health.ny.gov, or by fax to (518) 473-3395 with Reference Code SP/HPA3/90612 included in the subject line. Failure to include the required information in the subject line of your email or fax may result in your resume not being considered for this position. Resumes accepted until June 15, 2018.

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