Physical Therapists

Details

Client Name
NY_OGS_Department of Health

Job Type
Travel

Offering
Allied

Profession
Therapy

Specialty
Physical Therapist

Job ID
19258733

Job Title
Physical Therapists

Weekly Pay
$2726.46


Shift Details

Shift
5 Day Shifts X 8 Hrs

Scheduled Hours
40


Job Order Details

Start Date
10/13/2026

End Date
10/13/2028

Duration
24 Month(s)


Job Description
Due Date for asking questions: 10/07/2026


Submission Due: 10/09/2026


The overall mission of the Office of Health Insurance Programs is to optimize the health of Medicaid members by wisely using all available resources. OHIP is responsible for administering New York's Medicaid budget (approximately $65B for 2018) by collaborating with stakeholders across the health care industry including other state agencies, local and federal government agencies, providers, members, and community-based organizations. OHIP is also responsible for implementation of major initiatives including Medicaid Redesign, the Affordable Care Act, and State Administration of Medicaid.


Division functions:


Division of Medical and Dental Directors (DMDD)


The Division is responsible for the prior approval and pended claims functions for Durable


Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), private duty nursing,


hearing aids, vision care, and dental. The Division also manages the prior approval process


for out-of-state nursing home placements, high tech radiology, the Center for Operational


Excellence, and the Medical Indemnity Fund. The Bureau of Medical Review, within the


Division of Medical and Dental Directors, performs Medicaid operational functions including


prior authorization for supplies and services, review of pended claims for pricing, timeliness


of submissions and adherence to Medicaid claims submission policy, prior authorization for


Fee for Service (FFS) Medicaid members seeking admission to skilled nursing facilities out


of state, and operation of a call center to answer inquiries from providers and members


about prior approval.


Position Description:
• Conduct comprehensive review of DMEPOS requests for Medicaid members to determine if the service falls within the scope of coverage of the Medicaid Program and NYS Regulation.
• Professional clinical knowledge and judgement used to render decisions that ensure the requested item is appropriate to meet the individual's medical needs.
• Actively involved in the Fair Hearing process by providing supporting evidence in written format and represents the NYS Medicaid Prior Approval Department via telephone.
• Knowledgeable of NYCRR Title 10 and 18 regulations. Utilizes national standards for procedure and diagnosis coding, reviews appropriate combinations of medical services and is instrumental in identifying methods to prevent fraud and abuse.
• Works closely with physicians, outside stakeholders, and Medicaid members via written and telephonic correspondence.


Additional Skill Level, Experience or Other Requirements:
• Current license/registration
• Excellent oral and written skills required.
• Experience in prior approval of medical supplies/equipment/services or experience in examination of medical records, documentation, and proposed treatment plans for medical necessity
• Experience in evaluating, making recommendations, and writing medical justification for various DME
• Experience with Microsoft Office
• Willing to work weekend hours if needed
• Proficient in the use of standard office technology
• Ability to be flexible, innovative, and work in a team environment


Client Details

Address
99 Washington Ave, One Commerce Plaza, Albany, NY 12210

City
Albany

State
NY

Zip Code
12210


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