Review Vacancy
TitleMedicaid Eligibility Examiner 2
Occupational CategoryNo Preference
Bargaining UnitASU - Administrative Services Unit (CSEA)
Salary RangeFrom $43270 to $43270 Annually
Street Address NYS Department of Health, Division of Legal Affairs NY State of Health, Bureau of Appeals
Corporate Woods
Minimum Qualifications Candidates must be a current NYS County Department of Social Services employee with permanent competitive status and have two (2) or more years of service as a Social Welfare Examiner, Social Services Examiner, Eligibility Examiner 1, or Social Services Examiner, or in a position where the work involves responsibility for performing assignments in connection with determining financial eligibility, categorical classification, continued financial eligibility, and income maintenance. The work must involve the review and evaluation of applications and records, and interviewing applicants; OR one (1) year or more permanent service as a Senior Social Welfare Examiner, Senior Social Services Examiner, Eligibility Examiner 2, Senior Social Services Program Specialist, or in a position where the work involves responsibility for monitoring and assisting a group of employees establish financial eligibility for the various programs administered by the local social services district.
PREFERRED QUALIFICATIONS:
The preferred candidate will have knowledge and understanding of the Appeal process currently performed at the Local Departments of Social Services.
Duties Description Within the Division of Legal Affairs, NY State of Health Counsel, Bureau of Appeals, the incumbent of this position will supervise staff and assist with support activities related to appeals from eligibility determinations made by the NY State of Health, Health Plan Marketplace Duties include: assist with the scheduling of hearings and desk reviews; process consumer appeals; coordinate with the customer service provider regarding appeals requests; make arrangements for off-site hearings; process requests for reconsiderations and further appeals; ensure that appeals files are prepared and maintained; assist the legal staff; enter changes into NY-HX to effectuate appeal determinations; provide technical assistance on eligibility for Medicaid, CHP, advanced premium tax credits and cost sharing reductions and other related matters, including aid-to-continue; upload decisions to the HX systems; review cases with respect to status, aid-to-continue, compliance, and related issues; handle additional evidence received at hearings and make sure that evidence is properly stored; resolve discrepancies in various data match processes; ensure systems are operated in a manner consistent with federal and state statute and regulations; assist in the implementation of policy and regulation changes; work collaboratively with other DOH program areas to identify and discuss administrative changes, recommendations and suggestions to improve operations and solve problems; research applicant status, prior history, and the status of appeals requests, utilizing various data storage and retrieval systems; and perform functions necessary to assume the responsibilities of the Local Departments of Social Services pertaining to eligibility for health insurance programs and hearings regarding eligibility determinations.
Additional Comments Permanent appointment, full-time.
CONDITIONS OF EMPLOYMENT:
Candidates must be a current NYS County Department of Social Services employee.
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resources Management Group, RD/MEE2/15264
Email Address resume@health.state.ny.us
Address
Street Room 2217, Corning Tower Building
Empire State Plaza
Notes on ApplyingSubmit resume to Human Resources Management Group, RD/MEE2/15264, Room 2217, Corning Tower Building, Empire State Plaza, Albany, New York 12237-0012, or by email to resume@health.state.ny.us, or by fax to (518)473-3395 with a subject line RD/MEE2/15264. Applications will be accepted until the positions are filled.