Medicaid Eligibility Examiner 2 (NY HELPS) - 79193

Overview 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. Responsibilities Conduct initial and peer post-eligibility reviews, designed to evaluate the appropriateness of recipient eligibility determinations and/or whether enrollment processes were properly executed. Analyze 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. Qualifications Permanent: 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, OR 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. 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 1 SL. 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. Non-Competitive Candidates Via NY HELPS Program: Four years of full-time experience performing activities including determining eligibility for health care programs, etc. Substitution: College credit hours may substitute for up to two years of experience at the rate of 30 college credits equaling one year of experience. Preferred Qualifications Preferred candidates will have professional experience in public health insurance programs, including New York’s Medicaid and/or Medicare. They will have excellent verbal and written communication skills; strong analytical skills and attention to detail; strong organizational skills; proficiency in Microsoft Office; 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 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: 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