Medical Assistance Specialist 1 - Albany, United States - Health, Department of

Health, Department of

Verified Company

Albany, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Minimum Qualifications

Permanent Transfer:

Current Department of Health (DOH) employees with permanent or contingent-permanent status as a Medical Assistance Specialist 1; OR 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, Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 1.

For more information on the types of transfers, transfer eligibility criteria, and the current transfer determinations for your title, visit the following website.

Non-Competitive Minimum Qualifications :
Either 1: Six years of qualifying experience;

Or 2:
an Associate's degree AND four years of qualifying experience;

Or 3:
a Bachelor's or higher degree AND two years of qualifying experience.

Qualifying experience:
For the purposes of this examination, qualifying experience is performing one or more of the following activities in a health care delivery system including health care facilities; federal, State, or local health care agencies; hospitals; Medicaid programs; and/or other public or private health insurance programs:

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 consumerassisted 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 ratesetting, 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.
Conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.

Preferred Qualifications:
Critical thinking skills, analytical skills with Microsoft Excel, ability to solve problems independently. Professional work experience and/or education in accounting and trend analyses.

Duties Description

This incumbent will function as an analyst within the Division of Finance and Rate Setting, within the Bureau of Financially Distressed Hospitals (FDH).

The Bureau of Financially Distressed Hospitals Bureau's goal is to promote financial sustainability for healthcare providers, thereby improving health service quality, preserving access, and decreasing statewide provider reliance on State aid to fund operations.

In addition, this Bureau works directly with hospitals on their cash flow, hospital needs, and various payment mechanisms, including Directed Payment Templates (DPT), Vital Access Program (VAP) funding, and Vital Access Provider Assurance Program (VAPAP) awards.

Duties Include:

Gathers and validates requirements for eligibility systems and works with the Bureau's data analysts to implement financial thresholds and assessments; Reviews financial system change requests to ensure systems work correctly; Drafts, reviews, and updates training and guidance documents, provider manuals, and job aids for staff and contractors; Provides oversight to contractors involved with financially distressed hospitals through evaluation of program functions.

Reviews and evaluates operations of hospital providers, identifies deficiencies, and proposes corrective actions to ensure compliance with DOH and federal laws, rules, and regulations.

Additional Comments
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...

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.

Some positions may require additional credentials or a background check to verify your identity.