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One Commerce Plaza
Minimum Qualifications Twelve years of professional level work experience, three of which must have included managerial, decision-making, and/or oversight of a major health-related program or in the direction of a major administrative function of a large health-related organization. A bachelor’s degree may substitute for four years of the general professional experience.
Preferred candidate should have experience in Medicaid financing and/or rate setting. Specifically, the incumbent will be responsible for oversight and development of NYS Medicaid Managed Care rates (including Mainstream, Health and Recovery Plan, Managed Long Term Care and others – see below) and management of the State’s actuary. Knowledge of development of Medicaid capitation rates, NY’s managed care environment and relevant governing NYS regulations/statutes and Federal requirements (such as actuarial sound requirements) is preferred. A Master’s degree in Health Care Policy, Public Policy, Public Administration, Actuarial Sciences or a closely related field with experience involving analytical and quantitative work in health economics and/or health care financing is also preferred. Desired candidate will possess strong management and supervisory experience in the finance field and have the ability to handle multiple, competing priorities.
Duties Description The incumbent of this position will report directly to the Director of the Division of Finance and Rate Setting (DFRS) and will serve as the Deputy Director of DFRS for the Bureaus of Mainstream Managed Care and Managed Long-Term Care Reimbursement. Specific duties include directing the ongoing rate setting functions ($41.5B gross) and activities of the Bureaus of Mainstream Managed Care (MMC) and Managed Long-Term Care (MLTC) Reimbursement and State actuary. This includes rate setting responsibility for programs such as Mainstream Managed Care, Health and Recovery Plans (HARP), Essential Plan, MLTC Partial Capitation, Program of All-Inclusive Care for the Elderly (PACE), Medicaid Advantage, Medicaid Advantage Plus (MAP), Federally Qualified Health Center Supplemental Payment Program, Managed Care Stop Loss Program, and Value Based Payment. The individual will oversee the development and continued maintenance of the Managed Care (MC) plan acuity score methodology for MC reimbursement rates and facilitate the analysis of MC plan expenditure and premium revenue. The individual will direct team leads and the State's actuary in the research of State Medicaid claims/encounter data, Managed Care encounter data, and Medicaid Managed Care Operating report data as the base for rate setting; oversee audit engagements from State and Federal oversight agencies. The incumbent will develop and communicate Bureau/Division directives and policy changes and supervise their implementation and recommend program legislative and regulatory proposals to the Director of DFRS. This position includes extensive work in managed care health care reform initiatives; acting as a liaison within the DFRS to the Office of Mental Health, Office for People with Developmental Disabilities, Office of Alcoholism and Substance Abuse Services and the Federal Centers for Medicare and Medicaid Services in the development, update and maintenance of Medicaid capitation rates; representing the Director of DFRS when necessary in meetings and negotiations with other OHIP and DOH executive staff, other New York State agencies; control agencies such as the Division of the Budget and the Office of the State Comptroller; Federal agencies and auditors; and the Medicaid programs of other states. Finally, the position includes conducting presentations for the health care industry and governmental conferences, panel discussions and public seminars as requested.
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Notes on ApplyingSubmit resume, preferably in PDF format, to Human Resources Management Group, WN/HPD2/90600, Room 2217, Corning Tower Building, Empire State Plaza, Albany, New York 12237- 0012, or fax to (518) 473-3395, or by email to email@example.com, with Reference Code WN/HPD2/90600 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 will be accepted until November 23, 2018.