Medicaid Eligibility Examiner 2 (NY HELPS) - 79246, 15241, 79965

Duties Description The Bureau of Program Review (BPR) within the Division of Eligibility and Marketplace Integration, monitors contractor, health plan and local district compliance with State and Federal eligibility rules and regulations. Description The Bureau of Program Review (BPR) within the Division of Eligibility and Marketplace Integration, monitors contractor, health plan and local district compliance with State and Federal eligibility rules and regulations. Duties Description The primary responsibilities of these MEE 2 positions will include: They will participate in pre- and post-eligibility reviews, using eligibility policies, evaluation standards and applicable data systems and other resources. These reviews evaluate and monitor health plan, local district and/or other State agency compliance with State and federal Medicaid and Child Health Plus (CHPlus) rules and regulations involving recipient eligibility and enrollment processes. Performs the full range of supervisory duties including approving time off, maintaining time and attendance, conducting performance evaluations, and counseling subordinates in the performance of their work and in their adherence to employee policies. May provide or develop written material and orally explain and answer questions. Monitors the quantity and quality of work completed by staff to ensure accuracy and adherence to procedures and instructions; identifies and resolves inaccuracies. Minimum Qualifications Current New York State employee with one year or more of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner 2, SG-14. Permanent Transfer A New York State employee with one year or more of permanent or contingent-permanent, competitive service in a position allocated to SG-12 above and eligible for transfer under Section 70.1 of the Civil Service Law. Non-Competitive Candidates Via NY HELPS Program Either Three years of experience performing one or more of the following activities in a health care delivery system including health care facilities, health care agencies, hospitals, Medicaid programs, and/or other public or private health insurance programs Determining financial eligibility for healthcare to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations. Performing quality assurance activities to ensure compliance with laws, rule, regulations and policies and interpretation/application of standards of health care. OR 30 semester credit hours AND two years of experience performing one or more of the following activities in a healthcare delivery system including health care facilities, health care agencies, hospitals, Medicaid programs, and/or other public or private health insurance programs Determining financial eligibility for healthcare to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations. Performing quality assurance activities to ensure compliance with laws, rule, regulations and policies and interpretation/application of standards of health care. Provisional Appointment: In the absence of an eligible list with three or more candidates willing to accept a position, a temporary provisional appointment may be considered. For provisional appointment, candidates must meet one of the following minimum qualifications: Current New York State Department of Health employee with one year of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner 1 or Medicaid Eligibility Examiner 1SL. If three or fewer New York State Department of Health promotional candidates respond to this notice, the agency may, at its discretion, nominate a qualified employee for non-competitive promotion under the provisions of Section 52.7 of the Civil Service Law. Preferred Qualifications: Preferred candidates will have professional experience in public health insurance programs, including New York’s Medicaid and/or Medicare. Preferred candidates will also have excellent verbal and written communication skills; strong analytical skills and attention to detail; strong organizational skills; proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team, and to manage multiple priorities in order to meet deadlines; and experience using electronic data systems, such as eMedNY and NYSOH Back Office. Supervisory experience is a plus. Additional Comments: When reviewing qualifications, omissions and vagueness cannot be interpreted in the candidate’s favor. Candidates are responsible for providing accurate and clear descriptions of their experience demonstrating how they meet the minimum qualifications. 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: 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 View phone number on click.appcast.io or email View email address on click.appcast.io to make a request. The 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 of the position (beginning of the salary range). 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. #J-18808-Ljbffr New York State Department of Health