Utilization Review Nurse

Duties Description The Office of Mental Health is recruiting for a Resources & Reimbursement Agent 1/Trainee in the State Operations Finance Group. Reporting to an Associate Health Care Fiscal Analyst, G-23, the incumbent will be responsible for, but not limited to, the following: Supports the Associate HCFA in managing the Office of Mental Health’s annual revenue target which is established by the Division of Budget. Ensures that OMH is properly claiming, collecting, reconciling, transferring and tracking multiple revenue streams that exceed $1 billion annually. Collaborates with OMH facilities on Health Home Care Management matters. This involves tracking, downloading and reconciling remittances delivered through provider portals, loading patient care rosters into the HHCM system, and assisting with system accessibility issues. Prepares both monthly revenue reports and quarterly AR reports that are required by our counterparts in other agencies. Posts charges related to our indirect patient billing into the billing system. The incumbent will be the counterpoint to the Cash Management Unit in posting cash receipts. This is necessary to ensure proper separation of duties to support internal controls. Minimum Qualifications Non-Competitive HELPS – Trainee 1 ($53,764): Four years of experience conducting financial reviews and evaluations, determining payment sources, and developing and submitting claims for health care and treatment costs. Non-Competitive HELPS – Trainee 2 ($59,994): Five years of experience conducting financial reviews and evaluations, determining payment sources, and developing and submitting claims for health care and treatment costs. Journey Level ($66,951): Six years of experience conducting financial reviews and evaluations, determining payment sources, and developing and submitting claims for health care and treatment costs. Associate degree may substitute for two years of specialized experience; bachelor's degree may substitute for four years of specialized experience; master's degree may substitute five years of specialized experience; J.D. may substitute for six years of specialized experience. 55BC Opportunity: Must meet the Non-Competitive minimum qualifications above and Individuals certified eligible for the 55b/c program under the Governor’s Program to Hire Persons/Veterans with Disabilities pursuant to Section 55b/c of the Civil Service Law AND possess a Bachelor’s degree will also be considered. Please provide a copy of your eligibility letter and transcript with your response. Transfer Opportunity: Candidates must have permanent status as a Resources & Reimbursement Agent 1, SG-18 and be eligible for lateral transfer; OR be eligible to transfer via Section 70.1 or Section 52.6 of the Civil Service Law by having at least one year of permanent service in a qualifying title within two salary grades of this position. Additional Comments Employment with New York State offers unmatched benefits, individual support, and career mobility for motivated individuals including: NYS pension and retirement programs; annual cost of living and performance advance increases; comprehensive medical, dental, and vision plans; flexible spending accounts for health and dependent care; paid time off, including thirteen paid holidays per year, and paid personal leave, vacation leave, and sick leave. Specific scheduled hours and telecommuting availability for this position will be discussed during the interview process. Please note, employees are required to apply and obtain approval through management to telecommute according to operational needs and Agency Telecommuting Program Guidelines. The Mission of the New York State Office of Mental Health is to promote the mental health of all New Yorkers, with a focus on providing hope and supporting recovery for adults with serious mental illness and children with serious emotional disturbances. Applicants with lived mental health experience are encouraged to apply. OMH is deeply committed to supporting underserved individuals, organizations, and communities. To this end, OMH is focused on implementing activities and initiatives to reduce disparities in access, quality, and treatment outcomes for underserved populations. A critical component of these efforts is ensuring OMH is a diverse and inclusive workplace where all employees' unique attributes and skills are valued and utilized to support the mission of the Agency. OMH is an equal opportunity/affirmative action employer. This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). For the duration of NY HELPS, this title maybe filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply. At a future date, it is expected that employees hired under NY HELPS will have their non-competitive employment status converted to competitive status, without having to compete in an examination. Employees will then be afforded with all of the same rights and privileges of competitive class employees of New York State. While serving permanently in a NY HELPS title, employees may take part in any promotion examination for which they are qualified. #J-18808-Ljbffr