Position Information

NY HELPNo

AgencyMental Health, Office of

TitleMental Health Program Specialist 4, Central Office;

Occupational CategoryOther Professional Careers

Salary Grade27

Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)

Salary RangeFrom $106898 to $131665 Annually

Employment Type Full-Time

Appointment Type Contingent Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

Schedule

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

Location

County Albany

Street Address NYS Office of Mental Health

44 Holland Avenue

City Albany

StateNY

Zip Code12229

Job Specifics

Duties Description The Office of Mental Health is recruiting to fill a Mental Health Program Specialist 4, G-27 position in the Strategic Finance and Managed Care Group, Bureau of Managed Care and Data Analytics, Billing Unit. This bureau is responsible for developing Medicaid and commercial mental health billing and claiming guidance for both Medicaid managed care and commercial health insurance companies and OMH licensed and designated mental health providers. Additionally, the Billing Section oversees provider inquiries related to proper and timely payment, investigates complaints, and provides technical assistance on billing and claiming issues including collaborating with the NYS Department of Health to present information at Managed Care Policy and Planning forums and with the Managed Care Technical Assistance Center. The incumbent will be tasked with duties and responsibilities including but not limited to:

- Supervise and manage a team of eight employees. Responsibilities include establishing policies and procedures, delegating and reviewing work, training staff, approving time off, and evaluating performance.

- Lead the development and distribution of communications originating from the Bureau including issuing guidance and policies to providers and managed care organizations related to Medicaid managed care billing and claims adjudication.

- Develop and present briefings for key executive leadership on systemic MCO issues related to claims denials, provided viability, and member access concerns.

- Guide and relay decisions and approvals to team members responsible for managing provider inquiries and complaints, and representing the Bureau in routine, focused, operational, and targeted MCO surveys.

- Serve as a subject matter expert for Medicaid managed care and commercial mental health billing procedures and collaborate with other New York State human service agencies including Office of Addiction Services and Supports, Department of Health, Department of Financial Services, as well as other divisions within OMH on managed care or commercial insurer related billing issues and prescribe solutions as needed.

- Supports the above stakeholders through a detailed understanding of CPT, HCPCS, and ICD-10 coding standards; UB-04 (837i) and CMS-1500 (837p) claim forms; claims denial reason codes, and use of eMedNY.

- Provides the Strategic Finance and Managed Care Group with comprehensive knowledge of Ambulatory Patient Group (APG), and 3M-Solventum Grouper software; and the methodology used for services paid at APG, including peer groups, CPT weights, rate codes, procedure codes, modifiers, discounts, and other add-on coding specifications.

- Serve as OMH's billing liaison to the DFS to support oversight of commercial billing mandates, including new commercial behavioral health coverage requirements, Medicaid payment parity and reimbursement requirements.

- Oversee the maintenance of Medicaid APG and Non-APG commercial benchmark rates, and publication and reconciliation of commercial fee schedules.

- Maintain resources housed on the OMH commercial billing webpage and develop technical billing and claiming resources and other supports for commercial insurers and OMH licensed providers.

- Monitor and respond to commercial insurance billing inquiries via hosted OMH commercial billing mailbox system.

- Attend and present at various stakeholder forums on behavioral health care billing, commercial reimbursement requirements or other relevant areas.

- Monitor and review State and federal health care statutes, regulations, and policies to identify pertinent billing and finance related issues and assess their programmatic and financial impact on New York State Medicaid behavioral health managed care.

Minimum Qualifications Candidates must be employed by New York State to be eligible to apply for this position

Transfer:
Candidates must be employed by New York State to be eligible to apply for this position. Candidates must have one-year permanent service as a Mental Health Program Specialist 4, G-27 and be eligible for lateral transfer; OR be eligible to transfer via Section 52.6 of the Civil Service Law.

Additional Comments • The Mission of the New York State Office of Mental Health is to promote the mental health of all New Yorkers, with a focus on providing hope and supporting recovery for adults with serious mental illness and children with serious emotional disturbances. Applicants with lived mental health experience are encouraged to apply. OMH is deeply committed to supporting underserved individuals, organizations, and communities. To this end, OMH is focused on implementing activities and initiatives to reduce disparities in access, quality, and treatment outcomes for underserved populations. A critical component of these efforts is ensuring OMH is a diverse and inclusive workplace where all employees' unique attributes and skills are valued and utilized to support the mission of the Agency. OMH is an equal opportunity/affirmative action employer.

• Specific scheduled hours and telecommuting availability for this position will be discussed during the interview process. Please note, employees are required to apply and obtain approval through management to telecommute according to operational needs and Agency Telecommuting Program Guidelines.

Some positions may require additional credentials or a background check to verify your identity.

How to Apply

Name Jenna Hart

Telephone

Fax 5184863897

Email Address OMHHRM@OMH.NY.GOV

Address

Street NYS Office Of Mental Health

44 Holland Avenue

City Albany

State NY

Zip Code 12229

 

Notes on ApplyingTo be considered for this position, interested candidates should email a cover letter and resume in Microsoft Word or PDF format to omhhrm@omh.ny.gov. Please include the title of the position and Vacancy ID #210810 in the subject line of your email when applying.

You are advised that, should you accept a job offer with the Office of Mental Health, you may be required to be fingerprinted and pay a fingerprint fee.