Review Vacancy
TitleMedical Assistance Specialist 1 (NY HELPS) - 79962, 79963
Occupational CategoryOther Professional Careers
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $65001 to $82656 Annually
Street Address Division of Eligibility and Marketplace Integration/ Bureau of Quality Management and Change Control
295 Main Street, Ellicott Square
Minimum Qualifications Reassignment: Current NYS Department of Health (DOH) employee with permanent or contingent-permanent status as a Medical Assistance Specialist 1, G-18.
Transfer: Current NYS employee with one year or more of permanent or contingent-permanent, competitive service in a title eligible to transfer under Section 52.6 or Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 1, G-18.
NY HELPS: Six years of experience developing public or private health related policy; analyzing AND interpreting public or private health related policy to assist consumers; determining or reviewing financial eligibility for healthcare or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations; establishing mechanisms for the reimbursement and financing of health care services, including rate-setting, development of capitation reimbursement methodologies, and development of fee schedules; performing utilization review of requests for medical treatment including prior approval or authorization activities, adjudication of claims for payment and/or provider credentialing; AND/OR conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.
Substitution: An associate degree can substitute for two years of specialized experience; a bachelor’s degree can substitute for four years of experience; a master’s degree in a related field can substitute for five years of experience; and a doctorate in a related field can substitute for six years of experience.
Preferred Qualifications: Preferred candidates will have professional experience in public health insurance programs, including New York’s Medicaid and/or Medicare. Preferred candidates will also have excellent verbal and written communication skills; strong analytical skills and attention to detail; strong organizational skills; proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team, and to manage multiple priorities in order to meet deadlines; and experience using electronic data systems, such as eMedNY, WMS and NYSOH Back Office. Supervisory experience is a plus.
Duties Description The Bureau of Quality Management and Change Control (QMCC) oversees NY State of Health contact center operations and manages the change control process with the contractor, working with other bureaus to assess the impact of proposed changes, identifying impacts across program areas, and tracking all change requests. QMCC also monitors the quality of the contractor’s performance by conducting quality assurance reviews designed to identify trends and provide recommendations for improvement.
Under the general supervision of higher level staff, the MAS 1 incumbents will assist with the execution of QMCC’s objectives geared toward ensuring quality customer service at the NY State of Health contact center. Specific duties include, but are not limited to: provide supervision to paraprofessional staff; field electronic referrals from the contact center; work with appropriate staff to resolve consumer issues; conduct quality (QA) reviews of recorded consumer calls and document processing using established QA procedures; maintain cooperative working relationships with other units, division, departments, and agencies to facilitate the delivery of public health insurance. The incumbent may also: interpret and communicate a variety of Federal and State laws and codes to implement policies, procedures and maintain compliance in the delivery of public health insurance benefits; review, sign or authorize eligibility determinations; monitor the quantity and quality of work completed by staff to ensure accuracy and adherence to procedures and instructions; identify and resolve inaccuracies; and prepare, compile and organize data for various reports.
Additional Comments This position is part of the NYS HELPS program. No examination is required.
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...
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.
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
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resource Management Group, MVS/MAS1/79962,79963
Email Address resume@health.state.ny.us
Address
Street Room 2217, Corning Tower Building
Empire State Plaza,
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 MVS/MAS1/79962,79963 included in the subject line or by mail to Human Resources Management Group, MVS/MAS1/79962,79963, 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.