Eligibility Program Manager 3 (NY HELPS) - 15425, 15268

Overview The Division of Eligibility and Marketplace Integration is seeking to fill two Eligibility Program Manager G-664 level positions to serve as Bureau Directors within the Bureau of Consumer Relations and Local District Support and the Bureau of Long-Term Care and SSI-Related Populations. Incumbents will assist the Division Director and higher-level managerial staff in identifying mission-critical program objectives and executing program operations. Responsibilities Oversee the following program areas: Bureau of Consumer Relations and Local District Support – Manage a team of field staff who provide oversight and technical assistance to local Department of Social Services staff, the State Disability Review Unit, and the Operations Unit. Coordinate transaction processing for program areas requiring manual intervention. Bureau of Long-Term Care and SSI-Related Populations – Interpret, develop, and implement Medicaid eligibility policy for the aged, blind, and disabled, including long-term care services, Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD) and Medicaid Cancer Treatment Program (MCTP). Oversight of Medicaid Eligibility and Client Management System (MECM) implementation and federal legislation impacts. Provide oversight of staff managing eligibility and enrollment policy and operations, focusing on federal legislation impacting the Medicaid application and administration process, including H.R. 1 and the ongoing design and implementation of the Medicaid Eligibility and Client Management System (MECM) for complex Medicaid populations. Qualifications Minimum Qualifications Current NYS Department of Health (DOH) employee with permanent or contingent permanent status as an Eligibility Program Manager 3, M-4. Preferred Qualifications Expert knowledge of New York public health insurance program eligibility and enrollment policies, including LDSS and Medicaid enrollment. Experience with the Welfare Management System (WMS), eMedNY, NY State of Health, and the Medicaid Buy-In Program. Demonstrated ability to manage multiple priorities, lead multi-disciplinary teams, and meet deadlines. Excellent written and oral communication skills. Non-Competitive Candidates Via NY HELPS Program Minimum of a bachelor’s degree and six years of professional experience, four of which must include second-level supervision of professional staff. Performed one or more of the following activities: Overseeing and directing staff in eligibility determination for health insurance or consumer-assisted programs with financial eligibility criteria. Performing utilization review, including prepayment or post-payment review, prior approval or authorization activities, adjudication or pricing of claims, or analysis of health care patterns. Developing reimbursement mechanisms, capitation methodologies, fee schedule development, coding constructs, or reimbursement processing. Administering day-to-day program operations for budgeting, staffing, or program planning. Inspecting, assessing, or monitoring health insurance programs or health care facilities for compliance with laws, regulations, and policies. Planning, designing, developing, researching, or evaluating proposals to establish or refine health-related programs, including grant writing or contract evaluation. Performing quality assurance activities to ensure compliance with regulations. Additional Comments This position is part of the NYS HELPS program. No examination is required. #J-18808-Ljbffr New York State Department of Health