MEDICAID CONSULTANT

City of New York; New York (NY); In loco; USD 70.000 - 80.000; Tempo pieno

Descrizione del lavoro

The City of New York's Department of Social Services invites applications for a Principal Administrative Associate II to serve as a Medicaid Consultant within the Medicaid Eligibility Unit. You will interpret Medicaid policies for diverse caseloads and supervise teams to ensure timely processing in compliance with laws and guidelines.

You will lead trainings, perform audits, and support high-priority actions while coordinating with CASAs, MLTC, and other programs to improve accuracy and

Competenze

• Bachelor's degree and 2 years administrative experience, including supervisory duties.
• Associate degree with 3 years admin experience, including one year supervisory.
• High school diploma with 4 years admin experience, incl supervisory.
• Equivalent combination with one year supervisory experience.

Mansioni

• Interpret Medicaid policies for cases and ensure compliance with guidelines.
• Supervise Medicaid Eligibility Team Supervisors; assign work and ensure coverage.
• Provide second-level sign-off for adverse actions and proper documentation.
• Conduct random case reviews to verify correct decisions.
• Meet with supervisors to report problems and provide corrective training.
• Conduct training sessions for supervisors and specialists to reduce errors.
• Review computer error reports and ensure efficient control processes.
• Assist on high-priority cases like Tape Match, Fair Hearing, QA.

Formazione

Baccalaureate degree with 2 years admin experience

Associate degree or 60 credits with 3 years admin experience incl supervisory

High school diploma with 4 years admin experience incl supervisory

Education/experience equivalent to 1-3 with supervisory experience

Descrizione del lavoro

• Job Category: Administration & Human Resources
• Salary Band: $70,000 to $80,000
• Compensation: USD 61,656 - USD 70,904

Job Description

APPLICANTS MUST BE PERMANENT IN THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE

The Department of Social Services (DSS) is comprised of the administrative units of the New York City Human Resources Administration (HRA) and the Department of Homeless Services (DHS). HRA is dedicated to fighting poverty and income inequality by providing New Yorkers in need with essential benefits such as Food Assistance and Emergency Rental Assistance. DHS is committed to preventing and addressing homelessness in New York City by employing a variety of innovative strategies to help families and individuals successfully exit shelter and return to self-sufficiency as quickly as possible.

The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to medically fragile and vulnerable individuals who require assistance with activities of daily living through the Community Alternative Systems Agency (CASA), Managed Long Term Care (MLTC) Program, the Assisted Living Program, Care at Home Program and Homebound Medicaid. The Medicaid Eligibility Unit is responsible for the Medicaid eligibility review and processing of initial applications, change actions, and renewals for all Medicaid funded long term care programs. This unit is responsible for the processing of Medicaid eligibility for consumers who receive services through one of the HCSP programs.

The Medicaid Eligibility Unit is responsible for the Medicaid eligibility review and processing of initial applications, change actions, and renewals for all Medicaid funded long term care programs. This unit is responsible for the processing of Medicaid eligibility for consumers who receive services through one of the HCSP programs.

Home Care Services Program (HCSP) is recruiting for one (1) Principal Administrative Associate II, to function as a Medicaid Consultant who will:

• Interpret Medicaid policies and procedures for assigned cases for individuals applying for or in receipt of services through one of the CASA offices, the Managed Long-Term Care (MLTC) Program, the Long Term Home Health Care Program (Lombardi), Care At Home (CAH), the Assisted Living Program (ALP), and the Field Services/Homebound Unit to ensure that cases are processed in compliance with Federal, State, and City Guidelines.
• Supervise and distribute work schedules/assignments to the Medicaid Eligibility Team Supervisors, provide a timetable for efficient completion of work and ensure adequate coverage during the hours of operation.
• Provide second-level sign-off approval for all adverse case actions to ensure that the cases are properly documented, and that the appropriate processing protocols are applied.
• Conduct random review of completed cases to determine if the proper decision was made based on the documentation provided.
• Conduct meetings with Medicaid Eligibility Team Supervisors to advise on problems identified in their teams and provide written reports of meetings indicating problems found, resolution(s) initiated, and recommendations for corrective training.
• Conduct training sessions to provide Medicaid Eligibility Team Supervisors and/or Eligibility Specialists with correction and feedback based on the unit review to reduce or eliminate Quality Control errors.
• Review computer error reports, check for repetition of specific errors and follow up to determine reason for the errors. Review the control process to ensure that it is operating with maximum efficiency.
• Aid Medicaid Eligibility Team Supervisors and/or Eligibility Specialists on cases requiring resolution for high-priority actions such as Tape Match, Fair Hearing and Quality Assurance issues.

Hours/Shift: 9am - 5pm (FLEX)

PRINCIPAL ADMINISTRATIVE ASSOC - 10124

Qualifications

1. 1. A baccalaureate degree from an accredited college and two years of satisfactory full-time progressively responsible clerical/administrative experience, one year of which must have been in an administrative capacity or supervising staff performing clerical/administrative work of more than moderate difficulty; or
2. 2. An associate degree or 60 semester credits from an accredited college and three years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience described in "1" above; or
3. 3. A four-year high school diploma or its educational equivalent approved by a state’s department of education or a recognized accrediting organization and four years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience as described in "1" above; or
4. 4. Education and/or experience equivalent to "1", "2", or "3" above. However, all candidates must possess the one year of administrative or supervisory experience as described in "1" above. Education above the high school level may be substituted for the general clerical/administrative experience (but not for the one year of administrative or supervisory experience described in "1" above) at a rate of 30 semester credits from an accredited college for 6 months of experience up to a maximum of 3 year.

Additional Information

The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.