Medicaid Eligibility Examiner 2 (NY HELPS)

Medicaid Eligibility Examiner 2

The Bureau of Program Compliance and Audit (BPCA) interacts with external auditors such as Office of State Comptroller (OSC), Office of Inspector General (OIG), and the Center for Medicare and Medicaid Services (CMS) to ensure that local district and the New York State of Health eligibility determinations are in compliance with State and Federal eligibility rules and regulations.

The primary responsibilities of an MEE2 in BPCA include:

• Conduct initial and peer post-eligibility reviews, designed to evaluate the appropriateness of recipient eligibility determinations and/or whether enrollment processes were properly executed.
• Analyzing data and/or conduct case-specific research to identify cases for possible follow-up action because they appear to be at risk for irregularities or vulnerabilities, as needed.
• Conduct pre-review planning and preparation activities. Perform research and/or analysis in accordance with policies and procedures.
• Assist supervisors and superiors in tallying and aggregating review results, as well as editing summary reports, when necessary.
• Work with auditors in getting the proper access to the various systems and possibly answer questions received from the auditors.

This position is part of the NYS HELPS program. No examination is required. This position may require travel throughout New York State including overnights to areas not served by public transportation. 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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NYS Department of Health does not participate in E-Verify and does not sponsor visa applications.