Review Vacancy
AgencyMental Health, Office of
TitleBusiness Systems Analyst 2, Central Office;
Occupational CategoryOther Professional Careers
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $81705 to $103350 Annually
Appointment Type Contingent Permanent
Minimum Qualifications Non-Competitive HELPS:
Either A. a bachelor’s or higher degree AND three years of business analysis* experience where your primary duty was performing three of the five following activities:
1. Using business analysis techniques to elicit requirements as the foundation for the solution to the organization’s business needs (e.g., workshops, focus groups, interviews, observation, brainstorming, surveys/questionnaires, or JAD Sessions).
2. Using business analysis techniques for the purpose of identifying solutions aimed at improving the efficiency and effectiveness of the system, business process, or product/service to fulfill the business requirements (e.g., Data Flow Diagram, Business Process Model, Root Cause Analysis, Fish Bone Diagram, Context Diagram, Business Process Flows, or Fit-Gap Analysis).
3. Describing in a comprehensive written document what the system, process, or product service must do in order to satisfy the established business requirements; this includes creating, updating, and maintaining documentation through the system development life cycle (e.g., Business Case, Use Case, Business Requirement Document [BRD], Fit-Gap Analysis, Impact and Feasibility Analysis, or Change Management Analysis).
4. Validating requirements throughout the product/system development life cycle (SDLC) including all changes to the processes that would enable an organization to achieve its goals.
5. Verifying requirements throughout the product/system development life cycle (SDLC) to ensure they perform to the required specifications and are capable of achieving the design capabilities; this includes developing test plans/scenarios and logical designs, testing the scenarios, reviewing test results, identifying constraints and risks, and/or communicating with stakeholders.
Or B. a bachelor’s or higher degree AND possession of a Level 2 International Institute of Business Analysis/Certification of Capability in Business Analysis (IIBA/CCBA) Certification** AND one year of business analysis* experience where your primary duty was performing three of the five activities listed above.
Or C. possession of a Level 3 International Institute of Business Analysis/Certified Business Analysis Professional (IIBA/CBAP) Certification.**
**Information regarding IIBA certification can be found at: http://www.iiba.org/Certification/certificationlevels.aspx.
55 b/c Opportunity: Must meet the Non-Competitive minimum qualifications above and Individuals certified eligible for the 55b/c program under the Governor’s Program to Hire Persons/Veterans with Disabilities pursuant to Section 55b/c of the Civil Service Law AND possess a Bachelor’s degree will also be considered. Please provide a copy of your eligibility letter and transcript with your response.
Transfer Opportunity:
Candidates must have permanent status as a Business Systems Analyst 2, SG-23, and be eligible for lateral transfer; OR be eligible to transfer via Section 70.1 or Section 52.6 of the Civil Service Law by having at least one year of permanent service in a qualifying title within two salary grades of this position.
Preferred Qualifications:
• Understand revenue cycle systems from design, operations, testing, and training perspectives, such as Oracle Cerner's Soarian Financials billing application.
• Understand and experience in documenting requirements related to reimbursement methodologies (e.g., Diagnostic Related Groups (DRG), Ambulatory Payment Classification (APC), and Ambulatory Patient Groups (APG)).
• Understand government insurance plans (i.e., Medicaid and Medicare), commercial insurances and managed care, including both claims submission and remittance statement processes, edits, and errors from a revenue cycle system perspective.
• Understand medical coding terminology (e.g., HCPCS, CPT, and modifiers), to be able to communicate the business needs and rules to the Vendor consultants.
Duties Description The Office of Mental Health (OMH) is recruiting to fill a Business Systems Analyst 2 / Grade 23, position in the State Operations Finance Group, Billing Operations Team. The incumbent in this Business System Analyst-2 position will support the two billing teams (listed below) that are critical to maintaining and developing the core competencies to manage the annual revenue cycle of $1.1 billion.
The first team, Outpatient Billing and Reporting/Analytics team's responsibilities include:
• Manage systems used to claim myriad payors (Medicaid, Medicare, health plans, counties, private pay) for outpatient and residential services including the legacy and modernized billing systems. Requires analysis of claiming data including pre and post-go-live revenue trends, and follow-up on claim billing edits, denials, rejections, and overpayments.
• Ensure the billing system is kept updated for any changes to the Federal, State, and Payor guidelines for outpatient and residential billing. Work with the Vendor to make such changes to the system, as needed.
• Maintain various OMH billing data tables and build queries that integrate such data with other OMH data tables, including OMH electronic medical records systems and the NYS Medicaid Datawarehouse. Document such queries and processes, and perform regular and ad-hoc billing analyses to satisfy inquiries.
• Lead on the intensive annual independent, third-party audit of $600M in Disproportionate Share (DSH) payments received by OMH. In addition, prepare the annual Bad Debt analysis which is required to support more than $50M in annual Medicare reimbursements.
• Respond to any audit requests from internal groups and external agencies.
The second team, Inpatient Billing and Plan Contracting team's responsibilities include:
• Manage systems used to claim myriad payors (Medicaid, Medicare, health plans, counties, private pay) for inpatient services including the legacy and modernized billing systems. Requires analysis of claiming data and follow-up on claim billing edits, denials, rejections, and overpayments. Work with the Vendor, Facilities, and Finance Staff to take necessary actions to resolve these errors.
• Monitor and resolve Medicare Return to Provider (RTP) rejections, which includes high volume of rejections due to provider enrollments. Work with the facilities on enrollment-related claim issues, and prepare ongoing reports on such issues.
• Ensure the billing system is kept updated for any changes to the Federal, State, and Payor guidelines for inpatient/criminal order billing. Work with the Vendor to make such changes to the system, as needed.
• Assist with contracting efforts with health insurers, including Medicaid and Medicare Managed Care plans and Medicare Part D plans to ensure OMH is reimbursed appropriately for services rendered to patients. Further, oversee Medicare Part D (pharmacy) claiming management.
• Respond to any audit requests from internal groups and external agencies.
Additional Comments This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS).
For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply. At this time, agencies may recruit and hire employees by making temporary appointments. In May 2024, if a temporary NY HELPS employee is satisfactorily performing in the position, the appointment will be changed from temporary pending Civil Service Commission Action to permanent non-competitive and the official probationary period will begin.
At a future date (within one year of permanent appointment), it is expected employees hired under NY HELPS will have their non-competitive employment status converted to competitive status, without having to compete in an examination. Employees will then be afforded with all of the same rights and privileges of competitive class employees of New York State. While serving permanently in a NY HELPS title, employees may take part in any promotion examination for which they are qualified.
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.
Email Address OMHHRM@OMH.NY.GOV
Address
Street NYS Office of Mental Health
44 Holland Avenue
Notes on ApplyingTo be considered for this position, interested candidates should email a cover letter and resume as an attachment in Microsoft Word or PDF format to omhhrm@omh.ny.gov. Please include the title of the position and Vacancy ID #154342
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.