Medical Assistance Specialist 1

Permanent Transfer: Current Department of Health (DOH) employees with permanent or contingent-permanent status as a Medical Assistance Specialist 1; OR 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, Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 1. For more information on the types of transfers, transfer eligibility criteria, and the current transfer determinations for your title, visit the following website.

Non-Competitive Minimum Qualifications : Either 1: Six years of qualifying experience;
Or 2: an Associate's degree AND four years of qualifying experience;
Or 3: a Bachelor's or higher degree AND two years of qualifying experience.

Qualifying experience: For the purposes of this examination, qualifying experience is performing one or more of the following activities in a health care delivery system including health care facilities; federal, State, or local health care agencies; hospitals; Medicaid programs; and/or other public or private health insurance programs:

-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.
-Conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.

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, identify impacts across program areas, and track 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 live monitoring and quality (QA) reviews of recorded consumer calls 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; prepare, compile and organize data for various reports; may appear at judicial or administrative proceedings when required to interpret decisions; and develop and review eligibility scenarios to test new computer applications and systems.

Additional Comments 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:

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

Name Human Resources Management Group, SPD/MAS1/79961/HELPS

Telephone

Fax

Email Address

Address

Street Room 2217, Corning Tower Building

Empire State Plaza,

City Albany

State NY

Zip Code 12237

Notes on Applying Please submit your resume and cover letter as one (1) document, preferably in PDF format, by email to , with Reference SPD/MAS1/79961/HELPS included in the subject line or by mail to Human Resources Management Group, SPD/MAS1/79961/HELPS, Rm 2217, Corning Tower Building, Empire State Plaza, Albany, NY , or by fax to . Failure to include the required information may result in your resume not being considered for this position.