Eligibility Program Manager 2 (NY HELPS) - 15449 - StateJobsNY : Job Details

Competitive Minimum Qualifications:New York State employee with one or more years of permanent or contingent-permanent service in title at Grade 27 or above, and eligible for transfer to EPM 2, G29, under Section 70.4, 70.1 or 52.6 of the Civil Service Law.This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). HELPS Program titles may be filled via a noncompetitiveappointment. This means that you do not need to take an exam to qualify, but you do need to meet the minimum qualifications of the title.If you are hired via HELPS, at a future date (within one year of permanent appointment), employees hired under NY HELPS are expected to have their permanent non-competitiveemployment status converted to permanent competitive status. You will not have to take an exam to gain permanent competitive status.Non - Competitive Minimum Qualifications:A bachelor's degree and five years of professional experience, three years of which must have included second-level supervision of staff, performing one or more of the following seven activities* in a program with one or more of the following functions: provides reimbursements for health care services; works with social services program areas; determines eligibility for a consumer assisted program in a hospital or other health care facility; provides health care regulatory oversight; or performs quality assurance and interpretation/application of standards of health care. 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. Duties Description The Eligibility Program Manager 2 will serve as Deputy Bureau Director in the Bureau of Long-Term Care and SSI-Related Populations and assist in overseeing the Bureau's two units: the Long-Term Care/SSI-related Medicaid Policy and Initiatives Unit, and the Special Programs Policy and Integrity Support Unit. The deputy bureau director will be responsible for development, administration, oversight, and implementation of complex Medicaid Program eligibility policy for the aged, blind and disabled population and oversight of special programs and subordinate staff. The deputy bureau director will provide Medicaid financial eligibility policy expertise generally, to executive level staff, and for the implementation of key Medicaid eligibility initiatives, such as the system build required to incorporate the aged, blind and disabled (SSI-related) Medicaid eligibility group in a new state-based eligibility system; maintaining the policies and processes needed to support the Unwind of the COVID-19 emergency period and return to normal program operations; and operationalizing federal Medicaid regulations that require streamlining of application and renewal processes for aged, blind and disabled and other non-MAGI groups. The deputy bureau director will assist in determining priorities and overseeing operations within the units, training subordinate staff in subject matter expertise, and with Bureau succession planning. The deputy bureau director will provide programmatic policy guidance, requirements, and oversight to ensure adherence to federal and State regulations and requirements; interpret federal and State laws, rules and regulations to develop policy directives, analyses and other materials. 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: Some positions may require additional credentials or a background check to verify your identity.Name Human Resources Management Group, MVS/EPM2/15449 Telephone 518-###-#### Fax 518-###-#### Email Address [email protected] AddressStreet 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 [email protected], with Reference MVS/EPM2/15449 included in the subject line or by mail to Human Resources Management Group, MVS/EMP1/15449, Rm 2217, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0012, or by fax to (518) ###-####. Failure to include the required information may result in your resume not being considered for this position.