Position Information

NY HELPNo

AgencyHealth, Department of

TitleHealth Program Administrator 3 - 89617

Occupational CategoryAdministrative or General Management

Salary Grade27

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

Salary RangeFrom $111708 to $137590 Annually

Employment Type Full-Time

Appointment Type Contingent Permanent

Jurisdictional Class Competitive Class

Travel Percentage 5%

Schedule

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 9 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

Location

County Albany

Street Address Office of Health Insurance Programs/Division of Medical and Dental Directors/Bureau of Medical Review/Prior Approval Unit

99 Washington Avenue

City Albany

StateNY

Zip Code12231

Job Specifics

Duties Description The Health Program Administrator 3 is in the Office of Health Insurance Programs, within the Division of Medical & Dental Directors, in the Bureau of Medical Review/Prior Approval Unit. The Health Program Administrator 3 (G-27) position provides essential bureau-level management and operational oversight within the Division of Medical and Dental Directors’ Bureau of Medical Review. The HPA3 Prior Approval Unit Manager is responsible for directing the day-to-day operations of the Prior Approval Unit and ensuring timely, accurate, and consistent review of Medicaid prior approval requests for private duty nursing services, durable medical equipment, prosthetics, orthotics, medical supplies, hearing aids and out-of-state inpatient placements, as well as the review of claims for medical necessity and adherence to Department claims processing rules.

The HPA3 will provide administrative and operational leadership for multiple program areas, including personnel management, workload distribution, quality assurance, fiscal management, contract and vendor oversight, and resolution of complex operational issues. The position analyzes program data and performance metrics to identify trends, address workflow issues, improve efficiency, and ensure compliance with Department, Medicaid, and CMS requirements.

This position also serves as a subject matter expert on Medicaid durable medical equipment and related benefits, providing policy interpretation and technical guidance to Department leadership, Medicaid Managed Care plans, providers, manufacturers, and other stakeholders. Responsibilities include development and implementation of program policies; review and revision of procedure and provider manuals; evaluation of emerging technologies and benefit changes; and coordination of operational changes resulting from federal and State requirements.

This position is necessary to maintain effective management and continuity of Bureau operations, ensure appropriate oversight of high-volume and high-impact Medicaid programs, support staff and supervisors, maintain required prior authorization and claims review timeliness, and provide the leadership necessary to implement ongoing program, regulatory, technological, and operational changes.

Minimum Qualifications Permanent Transfer Candidates: Current NYS Department of Health employee with one year of permanent or contingent-permanent, competitive, service as a Health Program Administrator 3, SG-27, and eligible to transfer under Section 70.1 or Section 52.6 of the NYS Civil Service Law OR Current NYS employee with one year of permanent or contingent-permanent, competitive, service in a title SG-25 or higher and eligible to transfer under Section 70.1 or Section 52.6 of the NYS Civil Service Law.

Preferred Qualifications: Medicaid experience including an understanding of the eMedNY system; experience working with prior approvals/medical claims; policy development/implementation; excellent communication, written and organizational skills; ability to function independently and deal with multiple tasks and 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 may require travel throughout New York State including overnights to areas not served by public transportation.

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 518-486-1812 or email doh.sm.Reasonable.Accommodation@health.ny.gov 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.

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

How to Apply

Name Human Resources Management Group, EW/HPA3/89617

Telephone 518-486-1812

Fax 518-473-3395

Email Address resume@health.ny.gov

Address

Street Coring Tower, Empire State Plaza, Room 2217

City Albany

State NY

Zip Code 12237

 

Notes on ApplyingPlease submit your resume and cover letter as one (1) document, preferably in PDF format, by email to resume@health.ny.gov, with Reference EW/HPA3/89617 included in the subject line or by mail to Human Resources Management Group, EW/HPA3/89617, Rm 2217, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0012, or by fax to (518) 473-3395. Failure to include the required information may result in your resume not being considered for this position.