Review Vacancy
TitleMedical Assistance Specialist 1 (NY HELPS) - 61611- 61618
Occupational CategoryFinancial, Accounting, Auditing
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $65001 to $82656 Annually
Street Address OHIP/Division of Finance and Rate Settings/Division of Finance and Rate Settings/ Bureau of Financially Distressed Hospitals
99 Washington Avenue
Minimum Qualifications Permanent Transfer: Current Department of Health (DOH) employees with permanent or contingent-permanent status as a Medical Assistance Specialist 1; OR current NYS employee with one year or more of permanent or contingent-permanent, competitive service in a title eligible to transfer under Section 52.6, Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 1. For more information on the types of transfers, transfer eligibility criteria, and the current transfer determinations for your title, visit the following website.
https://careermobilityoffice.cs.ny.gov/cmo/gotit/index.cfm.
Non-Competitive Minimum Qualifications : Either 1: Six years of qualifying experience;
Or 2: an Associate's degree AND four years of qualifying experience;
Or 3: a Bachelor's or higher degree AND two years of qualifying experience.
Qualifying experience: For the purposes of this examination, qualifying experience is performing one or more of the following activities in a health care delivery system including health care facilities; federal, State, or local health care agencies; hospitals; Medicaid programs; and/or other public or private health insurance programs:
-Developing public or private health related policy.
Analyzing AND interpreting public or private health related policy to assist consumers.
-Determining or reviewing financial eligibility for healthcare or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations.
-Establishing mechanisms for the reimbursement and financing of health care services, including rate-setting, development of capitation reimbursement methodologies, and development of fee schedules.
-Performing utilization review of requests for medical treatment including prior approval or authorization activities, adjudication of claims for payment and/or provider credentialing.
-Conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.
Preferred Qualifications: Critical thinking skills, analytical skills with Microsoft Excel, ability to solve problems independently. Professional work experience and/or education in accounting and trend analyses.
Duties Description This incumbent will function as an analyst within the Division of Finance and Rate Setting, within the Bureau of Financially Distressed Hospitals (FDH).
The Bureau of Financially Distressed Hospitals Bureau’s goal is to promote financial sustainability for healthcare providers, thereby improving health service quality, preserving access, and decreasing statewide provider reliance on State aid to fund operations. In addition, this Bureau works directly with hospitals on their cash flow, hospital needs, and various payment mechanisms, including Directed Payment Templates (DPT), Vital Access Program (VAP) funding, and Vital Access Provider Assurance Program (VAPAP) awards.
Duties Include:
Organize hospital data to determine hospital financial allocation plans and develop funding options; Establish hospital metrics for demonstrating improvement, and monitoring data reported against those metrics; Manage a distressed hospital dashboard to ensure an accurate and complete view of hospital submitted data elements; Oversee the monitoring and oversight of hospital metrics and financial management of funding allocations; Facilitate the integration of hospital reporting with other Medicaid and Department of Health data to assess regional and/or hospital specific trends as well population health activities; Review FDH applications and financial sustainability plans.
Build automated reports in Tableau that organize FDH information (cash flows, revenues, expenses, utilization, etc.) to translate data into meaningful reports that can assist stakeholders in transformation planning purposes; Reviews and evaluates laws, rules, and regulations related to Medicaid and hospitals to improve the support of financially distressed hospital operations, and to ensure compliance of existing programs with new or changing requirements or guidelines; Analyzes State and federal legislation related to FDH financial opportunities, and review for impact on existing program operation; Provides technical assistance to various stakeholders on regulatory changes and impacts on supportive hospital program operations; Research distressed hospital health care topics to ensure that support programs and policies are evidence-based, and consistent with department goals; Drafts hospital financial reports, policies, and procedures for internal and external review and distribution; Responds to routine information requests from providers, insurance plans, advocates, and other agencies; Reviews and evaluates FDH reports and program data to identify deficiencies, perform quality assurance and program audit functions, and to improve administration of distressed hospital support programs; Reviews applications for FDH funding plans and programs.
Gathers and validates requirements for eligibility systems and works with the Bureau’s data analysts to implement financial thresholds and assessments; Reviews financial system change requests to ensure systems work correctly; Drafts, reviews, and updates training and guidance documents, provider manuals, and job aids for staff and contractors; Provides oversight to contractors involved with financially distressed hospitals through evaluation of program functions.
Reviews and evaluates operations of hospital providers, identifies deficiencies, and proposes corrective actions to ensure compliance with DOH and federal laws, rules, and regulations.
Additional Comments The Medical Assistance Specialist 1 title is part of the NYS HELP program. For the duration of the HELP Program, this title will be filled via permanent non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the titles for which they apply. At the close of the HELP program, employees hired under the HELP Program will have their non-competitive employment status converted to competitive status. Employees will then be afforded with all of the same rights and privileges of competitive class employees of New York State.
Depending on how the candidates qualifies, the positions could be filled as competitive or non-competitive.
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: https://health.ny.gov/commissioner/index.htm
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resources Management Group, SCD/MAS1/61611-61618
Email Address resume@health.ny.gov
Address
Street Rm 2217, Corning Tower Building, Empire State Plaza
Notes on ApplyingPlease submit your resume and cover letter, preferably in PDF format, by email to resume@health.ny.gov, with Reference SCD/MAS1/61611-61618 included in the subject line or by mail to Human Resources Management Group, SCD/MAS1/61611-61618, 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.