NY HELPNo

AgencyHealth, Department of

TitleMedical Assistance Specialist 2 - 79384

Occupational CategoryAdministrative or General Management

Salary Grade23

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

Salary RangeFrom $86681 to $109650 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

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

County Albany

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

99 Washington Avenue

City Albany

StateNY

Zip Code12210

Duties Description The Medical Assistance Specialist 2 (MAS2), Grade 23, will assist in supervising the Medical Pended Claims Unit within the Bureau of Medical Review for the Office of Health Insurance Programs (OHIP), Division of Medical and Dental Directors. The Medical Pended Claims Unit is responsible for the review of Medicaid fee-for-service (FFS) claims for medical necessity, timely filing, requests for two-year waivers of claims processing, high-cost outlier claims, and claims pending for eMedNY systems edits. The MAS2 will manage the Provider on Review Unit responsible for reviewing and enforcing provider audit findings; identifying and monitoring fraud, waste and abuse in the Medicaid Fee-for-Service Program; overseeing implementation of corrective action plans; and maintaining program integrity. Additionally, the successful candidate will provide managerial oversight for the supervisors of the High-Cost Outlier (HCO) Unit and 2-year Review Unit. The incumbent will assist with the reporting and resolution of issues with the Enteral Authorization Web Portal and Interactive Voice Response (IVR) DiRAD systems through the vendor. Additional duties include providing policy guidance to staff and providers, conducting staff evaluations, coordinating training and quality assurance, and managing unit workloads. The role also includes integral participation in the Irregular Billing Committee, updating training documents, and preparing statistical and analytical reports for management from Medicaid Data Warehouse (MDW). The MAS2 will respond to program information requests, assist with researching and resolving audit findings, and support problem resolution efforts. Other duties may be assigned as needed. Telecommuting may be considered after one year of employment for individuals not currently working within the Bureau of Medical Review.

Minimum Qualifications Reassignment:
Current Department of Health (DOH) employee with permanent or contingent-permanent status as a Medical Assistance Specialist 2, G-23.

Transfer:
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 or Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 2, G-23.

Preferred Qualifications: Knowledge of Microsoft Office Suite, Medicaid Program and/or eMeNY system preferred.

Additional Comments 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.

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 (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.

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

Name Human Resources Management Group

Telephone 518-486-1812

Fax 518-473-3395

Email Address resume@health.ny.gov

Address

Street Corning 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 SPD/MAS2/79384 included in the subject line or by mail to Human Resources Management Group, SPD/MAS2/79384, 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.