Medical Assistance Specialist 1 (NY HELPS) - 80167

Job Title

This position is located in the Bureau of Program Implementation and Enrollment in the Division of Health Plan Contracting and Oversight and will provide support in the oversight of Managed Care Organizations (MCO) doing business within NYS. This is a key support position that will assist with assessing, implementing, drafting and/or developing policies, procedures, and operational guidelines, and related documentation associated with Medicaid Managed Care program implementation and enrollment. This position will also be responsible for triaging and responding to emails for multiple bureau mail logs (BMLs) that receive questions from consumers, stakeholders, DOH staff, Local District of Social Services (LDSS) staff, as well as other state agencies. This position will also play a key role in supporting stakeholder meetings. This position is located in the Program Implementation unit but will also provide related enrollment support to the Medicaid Managed Care Systems Operations unit.

Minimum Qualifications

Reassignment: Current NYS Department of Health (DOH) employee with permanent or contingent-permanent status as a Medical Assistance Specialist 1, G-18.
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 1, G-18.
NY HELPS: Six years of experience 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; AND/OR conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.
Substitution: An associate degree can substitute for two years of specialized experience; a bachelor's degree can substitute for four years of experience; a master's degree in a related field can substitute for five years of experience; and a doctorate in a related field can substitute for six years of experience.
Preferred Qualifications: The preferred candidate will have strong written and organizational skills, ability to manage multiple priorities, and be able to work both independently and as part of a team. Knowledge of the Managed Medicaid Program is preferred.

Additional Comments

This position is part of the NYS HELPS program. No examination is required.
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...
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:
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