Medical Assistance Specialist 1 (NY HELPS) - 94209

Description

Duties Description

The Medical Assistance Specialist 1 (MAS 1) will work within the Division of Eligibility and Marketplace Integration’s (DEMI) Bureau of Community Enrollment and Eligibility Processing to provide support to expand health insurance to New York’s neediest and most vulnerable populations, with a specific focus on implementation of Federal policy changes from H.R.1/ “One Big Beautiful Bill Act” of 2025.

Specific duties and responsibilities may include, but are not limited to:

• Assist local social service districts, state agencies, consumers, health care providers, advocacy groups, and professional organizations.
• Analyze state and federal laws and regulations to ensure accuracy in implementation.
• Assist with the transition of program operations from the local social services districts to NY State of Health.
• Assist in developing operational procedures, instructions, and guidelines to support the unit’s goals and priorities.

Qualifications

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 strong analytical skills, good oral and written communication skills, and be detail oriented. Candidates should have proficiency in Microsoft Office (Outlook, Word, Excel); the ability to work well independently and as part of a team and to manage multiple priorities to meet deadlines. Professional experience with public health insurance programs, including Medicare, Medicaid, Essential Plan, and/or Child Health Plus and supervisory experience is helpful.

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:

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 [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.