Position Information

NY HELPNo

AgencyHealth, Department of

TitleHealth Program Director 1 - 90603

Occupational CategoryHealth Care, Human/Social Services

Salary Grade664

Bargaining UnitM/C - Managerial/Confidential (Unrepresented)

Salary RangeFrom $127507 to $160911 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Non-competitive Class

Travel Percentage 5%

Schedule

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 9 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

Location

County Albany

Street Address Division of Health Plan Contracting and Oversight

99 Washington Avenue

City Albany

StateNY

Zip Code12210

Job Specifics

Duties Description Reporting to the Deputy Director of the Division of Health Plan Contracting and Oversight, the Health Program Director 1 will direct the Bureau of Managed Care Certification and Surveillance and will be responsible for the following:

• Oversee the development, review, and update of policies and procedures for certification and surveillance functions, including, but not limited to: issuance and revision of Certificates of Authority, management and provider contract review and approval; oversight of utilization review; provider network analysis; mental health parity compliance, operational surveys and enforcement proceedings.

• Manage day-to-day operations of the bureau and provide leadership to over 30 professional staff who are primarily responsible for certifying managed care organizations (MCOs) as well as surveying them to ensure that MCOs provide quality, accessible care to their enrollees consistent with all applicable federal and state statutes, regulations and contract requirements.

• Serve as primary liaison with Medicaid insurers in the State. Monitor managed care surveillance and reporting to ensure timely scheduling, issuance of results, appropriateness of identified issues and follow-up activities. Promote statewide consistency in work products through policy interpretation and guidance.

• Oversee the use of specialized focused surveys on an as needed basis. Analyze results of all surveys, and other plan performance data, including Statements of Deficiencies issued to plans, for trends or areas of concern and make recommendations.

• Interpret relevant federal and state legislation and develop state legislation, regulations and policies. Analyze impact on current policies and initiatives; develop implementation plans for new initiatives. Prepare federal reporting as required.

• Coordinate with other state and federal offices, such as other bureaus within the Division of Health Plan Contracting and Oversight, the Division of Legal Affairs, the Department of Financial Services, the Office of Health Services Quality and Analytics, the Office of the Medicaid Inspector General, and the Center for Medicaid and Medicare Services, to advance program objectives and develop and implement policy changes.

• Oversee database development and design, computer systems support, and other record retention systems to facilitate office regulatory functions.

• Prepare budget reports for staffing purposes, and management reports to support the objectives of the bureau and the Division.

• Make presentations and attend stakeholder meetings on a regular basis.

Minimum Qualifications Eleven years of professional experience, of which two years must have included managerial responsibility for a major health-related program, or a major administrative function for a large health-related organization.

A bachelor’s degree may substitute for four years of the professional experience described above; a master’s degree in an appropriate field may be substituted for an additional year of that experience.

Preferred Qualifications: Significant experience working in the State’s Medicaid program or other health insurance market including managed care experience, preferably in the government programs e.g., Medicaid managed care experience, and/ or a professional level working knowledge and experience associated with all aspects of Medicaid and public health programs including ensuring compliance with federal and state requirements. Candidates should be familiar with the operation and functions of the State's Medicaid managed care program and the relationship with other State agency partners including OMH, OASAS, OMIG, OPWDD. Ability to work under high pressure and manage multiple priorities. Excellent writing, communication, collaboration, and organizational skills.

Additional Comments This position may require travel throughout New York State including overnights to areas not served by public transportation.

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.

How to Apply

Name Human Resources Management Group

Telephone 518-486-1812

Fax 518-473-3395

Email Address resume@health.ny.gov

Address

Street Corning Tower, Empire State Plaza, Room 2217

City Albany

State NY

Zip Code 12237

 

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/HPD1/90603 included in the subject line or by mail to Human Resources Management Group, EM/HPD1/90603, 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.