Eligibility Program Manager 2 (NY HELPS) - 15449

New York State Department of Health; City of Albany (NY); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Holiday & Paid Time Off

Public Service Loan Forgiveness (PSLF)

Pension from NYS Employees’ Retirement

Shift & Geographic pay differentials

Affordable Health Care options

Family dental and vision benefits

Deferred Compensation plan

529 College Savings Program

Job summary

The New York State Department of Health seeks an Eligibility Program Manager 2 to serve as Deputy Bureau Director within the Office of Health Insurance Program. You will oversee three units, lead complex Medicaid eligibility policy for the aged, blind, and disabled, and guide system-build efforts for MECM and related initiatives.

You will interpret federal and state laws, set policy directives, train staff, and ensure compliance with regulations while supporting executive leadership.

Qualifications

• Current NYS DOH employee with permanent or contingent permanent status as a Eligibility Program Manager 2, G-29.
• Open to the Public: NY HELPS program eligibility pathway described, with related qualifications.

Responsibilities

• Oversee the Bureau’s three units: SSI-R Chronic Care, SSI-Related Community Coverage, and Special Programs Policy and Integrity Support.
• Develop, administer, and oversee Medicaid eligibility policy for aged, blind, and disabled populations and implement key eligibility initiatives.

Skills

Policy development

Leadership

Staff supervision

Communication

Tools

eMedNY

WMS

Medicaid policy frameworks

Job description

Duties Description

In the Office of Health Insurance Program's Division of Eligibility and Marketplace Integration, within the Bureau of Long-Term Care and SSI-Related Populations, the Eligibility Program Manager 2 will serve as Deputy Bureau Director and assist in overseeing the Bureau’s three units: the SSI-R Chronic Care Unit, the SSI-Related Community Coverage 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 for the Supplemental Security Income (SSI) related Medicaid eligibility group in a new state-based eligibility system, the Medicaid Eligibility and Client Management System (MECM) and will be instrumental in providing programmatic rules to assist with the system design; and operationalizing federal Medicaid regulations that require streamlining of application and renewal processes for aged, blind and disabled and other non-modified adjusted gross income (MAGI) groups. The Deputy Bureau director will assist in determining priorities and overseeing operations within the units, assisting in the redesign of work functions under the new system, and training subordinate staff in subject matter expertise. 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.

Description

Duties Description

In the Office of Health Insurance Program's Division of Eligibility and Marketplace Integration, within the Bureau of Long-Term Care and SSI-Related Populations, the Eligibility Program Manager 2 will serve as Deputy Bureau Director and assist in overseeing the Bureau’s three units: the SSI-R Chronic Care Unit, the SSI-Related Community Coverage 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 for the Supplemental Security Income (SSI) related Medicaid eligibility group in a new state-based eligibility system, the Medicaid Eligibility and Client Management System (MECM) and will be instrumental in providing programmatic rules to assist with the system design; and operationalizing federal Medicaid regulations that require streamlining of application and renewal processes for aged, blind and disabled and other non-modified adjusted gross income (MAGI) groups. The Deputy Bureau director will assist in determining priorities and overseeing operations within the units, assisting in the redesign of work functions under the new system, and training subordinate staff in subject matter expertise. 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.

Qualifications

Minimum Qualifications

Reassignment: Current NYS Department of Health (DOH) employee with permanent or contingent permanent status as a 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

• Overseeing and directing staff in determining eligibility for a health insurance program or consumer assisted program in which financial eligibility criteria must be met.
• 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.
• 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.
• Administering and overseeing staff responsible for day to day program operations for budgeting, staffing, or program planning.
• 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.
• 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.
• 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 experience in New York Medicaid program eligibility and enrollment policies and operations and with related data systems such such as eMedNY, NY State of Health and WMS; have experience developing and/or interpreting policies, procedures, statutes and regulations; work well both independently and as part of a team and under pressure to meet deadlines; possess excellent oral and written communication skills and excellent organizational and interpersonal skills; have strong research and analytical skills; and experience supervising staff and determining priorities.

Additional Comments

When reviewing qualifications, omissions and vagueness cannot be interpreted in the candidate’s favor. Candidates are responsible for providing accurate and clear descriptions of their experience demonstrating how they meet the minimum qualifications.

This position is part of the NYS HELPS program. No examination is required.

This position may require travel throughout New York State including overnights to areas not served by public transportation.

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: https://health.ny.gov/commissioner/index.htm

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 [phone] or email [e-mail] to make a request.

The 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 of the position (beginning of the salary range). 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.