Twelve years of professional experience, of which three years must have included managerial responsibility for a major health-related program, or a major administrative function for a large health-related organization. A bachelor’s degree may substitute for four years of the professional experience; a master’s degree in an appropriate field may be substituted for an additional year of professional experience.
Preferred Qualifications: Preferred candidate should have experience in Medicaid financing and/or rate setting. Specifically, the incumbent will be responsible for oversight and development of NYS Medicaid Managed Care rates (including Mainstream, Health and Recovery Plan, Managed Long Term Care and others – see below) and management of the State’s actuary. Knowledge of development of Medicaid capitation rates, NY’s managed care environment and relevant governing NYS regulations/statutes and Federal requirements (such as actuarial sound requirements) is preferred. A Master’s degree in Health Care Policy, Public Policy, Public Administration or a closely related field with experience involving analytical and quantitative work in health economics and/or health care financing is also preferred. Desired candidate will possess strong management and supervisory experience in the finance field and have the ability to handle multiple, competing priorities.

Reporting directly to the Director of the Division of Finance and Rate Setting (DFRS), the incumbent will serve as the Deputy Director of DFRS for the Bureaus of Mainstream Managed Care and Managed Long-Term Care Reimbursement. Specific duties include: Directing the ongoing rate setting functions ($54B gross) and activities of the Bureaus of Mainstream Managed Care (MMC) and Managed Long-Term Care (MLTC) Reimbursement and State actuary. This includes rate setting responsibility for programs such as: 1) Mainstream Managed Care; 2) Health and Recovery Plans (HARP); 3) Essential Plan; 4) MLTC Partial Capitation; 5) Program of All-Inclusive Care for the Elderly (PACE); 6) Child Health Plus; 7) Medicaid Advantage Plus (MAP); 8) Federally Qualified Health Center Supplemental Payment Program; and 9) Managed Care Stop Loss Program; Overseeing the development and continued maintenance of the Managed Care (MC) plan acuity score methodology for MC reimbursement rates; Facilitating the analysis of MC plan expenditure and premium revenue. Directs team leads and the State's actuary in the research of State Medicaid claims/encounter data, Managed Care encounter data, and Medicaid MC Operating report data as the base for the analysis; Overseeing audit engagements from State and Federal oversight agencies. Specifically, these engagements require staff representation in meetings, data extraction, rate methodology review, and audit response documentation; Developing and communicating Bureau/Division directives and policy changes and supervise their implementation; Recommending program legislative and regulatory proposals to the Director of DFRS and overseeing the preparation of required budgetary documents; Providing program evaluation and feedback on fiscal policy to the Director of DFRS as well as other Division executive staff inclusive of extensive work in managed care health care reform initiatives; Conducting presentations and represents DOH, OHIP and DFRS at health care industry and governmental conferences, panel discussions and public seminars as requested; Representing the Director of DFRS when necessary in meetings and negotiations with other OHIP and DOH executive staff, other New York State agencies; control agencies such as the Division of the Budget and the Office of the State Comptroller; Federal agencies and auditors; and the Medicaid programs of other states; and Acting as a liaison within the DFRS to the Office of Mental Health, Office for People with Developmental Disabilities, Office of Alcoholism and Substance Abuse Services and the Federal Centers for Medicare and Medicaid Services in the development, update and maintenance of Medicaid capitation rates;