Eligibility Program Manager 2 (NY HELPS) - 15448

The duties that the incumbent of the vacancy will be expected to perform. Duties Description The Eligibility Program Manager 2 (EPM 2) in the DEMI Bureau of Exchange Application Support (BEAS) will serve as the Assistant Director of the Bureau and manage its day-to-day operations related to task processing, Appeals task processing, reporting, systems activities and quality assurance. The EPM 2 will provide support to the Bureau Director on short- and long-range planning, identification of Bureau priorities, staffing plans, and organizational structure. The incumbent will manage multiple tiers of staff, respond to employee relations matters, and adjust staff assignments within the organizational structure to best address workloads and the skills of the staff and managers. Duties of this position may include but not be limited to: • Serve as a liaison to the NY State of Health/Medicaid Eligibility Client Management (MECM) customer service contractor, providing guidance on policies and procedures, approving contractor training materials and work instructions;•Review and approve test plans•Participate in project planning activities related to eligibility, enrollment and back-office operations for the NY State of Health and MECM; •Provide research support for audit activities and problems raised by the Bureau, Division or Exchange management; •Act as a subject matter expert on NY State of Health and MECM application processing.

The minimum qualifications required for this vacancy. Minimum Qualifications Reassignment: Current NYS Department of Health (DOH) employee with permanent or contingent permanent status as an Eligibility Program Manager 2, G-29 Permanent Transfer Candidates: Current NYS employee with one year of permanent or contingent permanent competitive service in a title Grade 27 or above eligible for transfer to Eligibility Program Manager 2 under Section 70.1 or 52.6 of the Civil Service Law.The transfer cannot be a second consecutive transfer resulting in an advancement of more than two salary grades.Open to the Public: This title is part of the New York Hiring for Emergency Limited Placement Statewide program (NY HELPS). For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, if the candidate meets the below NY HELPS minimum qualifications.NY HELPS Non-Competitive Minimum Qualifications: Nine years of professional experience*, three years of which must have included second-level supervision of professional staff, performing one or more of the following seven activities* in a program with one or more of the following functions 1. Overseeing and directing staff in determining eligibility for a health insurance program or consumer assisted program in which financial eligibility criteria must be met.2. Overseeing and directing staff in performing utilization review, including prepayment or post-payment review of requested health care services, prior approval or authorization activities, adjudication or pricing of claims for payment, or analysis of patterns of health care.3. Overseeing and directing staff in developing mechanisms for the reimbursement and financing of health care services, including rate-setting or approval, capitation reimbursement methodologies, fee schedule development, coding constructs for medical goods and services, or application and processing of reimbursement methodologies.4. Administering and overseeing staff responsible for day-to-day program operations for budgeting, staffing, or program planning.5. Overseeing and directing staff in inspecting, assessing, or monitoring health insurance programs or health care facilities for certification, licensure, or adherence to laws, rules, regulations, and policies.6. Overseeing and directing staff in planning, designing, developing, researching, or evaluating proposals to establish or refine health related programs, with responsibility for interpreting legislation or regulations, defining and describing target populations and local demographics, grant and proposal writing, or developing, reviewing, and evaluating contracts.7. Administering and overseeing staff responsible for performing quality assurance activities such as ensuring compliance with laws, rules, regulations, and policies, as it pertains to activities 1 through 6.*A Bachelor's Degree can substitute for four years of experience; a Master's Degree can substitute for five 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 and NYSOH Back Office. Supervisory experience is a plus.

Additional comments regarding the vacancy. 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...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: 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 [email protected] 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.

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