Medical Assistance Specialist 1 (NY HELPS) - 79962

Description Duties Description This Medical Assistance Specialist 1 (MAS 1) will work within the Division of Eligibility and Marketplace Integration (DEMI), Bureau of Downstate Eligibility Systems. Specific duties and responsibilities may include but are not limited to: Lead or participate in tasks involving requirements gathering, validation of requirements with policy staff, and analysis and provision of business requirements for the new eligibility system to vendors and/or other DOH staff. Initiate and complete tasks necessary to produce and implement needed system change requests (CRs). Work with teams of vendors, DOH staff and other stakeholders as needed (e.g. issuers, application assistors) to elicit, document, analyze, resolve issues, and provide technical assistance on implementation of business requirements in one or more of the Units within the Bureau. Prepare or review training documents and deliver training to small or large groups. Develop business requirements for legally required consumer notices. Tasks include: Revising and reviewing notice triggering rules Writing and revising key messages to communicate legally required information to consumers Developing message triggering rules based on new and existing system functionality Providing design input on notices Qualifications 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 Experience in public health insurance programs, including New York’s Medicaid and/or Child Health Plus Experience with data systems including, but not limited to, the Welfare Management System (WMS), NY State of Health Back Office and eMedNY; Ability to research and analyze information Demonstrated experience in requirements gathering and analysis of policy guidance Strong, writing, verbal communication, interpersonal, and organization skills and ability to work well under pressure. Supervisory experience The candidate must have strong organizational skills and the ability to adapt to changing priorities and tight timeframes. 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. 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. 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. #J-18808-Ljbffr New York State Department of Health