Medicaid Program Advisor

Medicaid Program Advisor

Albany, NY (Hybrid: 50% Onsite / 50% Remote)

The Bureau of Specialized Services for Children (BSSC) within the Division of Program Development and Management (DPDM) is seeking a Medicaid Program Advisor 1 to support critical programs serving children and youth with behavioral health needs, developmental disabilities, medical complexities, and foster care involvement.

This role combines program administration, eligibility assessment, care coordination, policy development, stakeholder engagement, and process improvement. The ideal candidate is passionate about improving access to care and services for children and families while working collaboratively with providers, community organizations, and government partners.

Key Responsibilities

HCBS Eligibility & Enrollment

• Conduct Home and Community Based Services (HCBS) eligibility determination assessments for Children's Waiver applicants.
• Manage referrals and guide applicants and families through the eligibility and enrollment process.
• Gather and evaluate assessment information from applicants, providers, and other stakeholders.
• Determine eligibility and enroll qualified participants into the Children's Waiver program.
• Facilitate participant transfers to their selected Children's Health Home or provide HCBS care coordination services as appropriate.

Program Administration & Support

• Develop expertise in Children's Health Home, Children's Waiver, Children and Family Treatment and Support Services (CFTSS), and Foster Care/29-I services.
• Assist with program planning, implementation, evaluation, reporting, and continuous improvement initiatives.
• Provide education, technical assistance, and guidance to providers, participants, families, and community stakeholders.

Policy Development & Compliance

• Research Medicaid regulations, policies, and program requirements.
• Develop and revise policies, procedures, provider guidance documents, and operational materials.
• Draft program communications, announcements, training materials, and presentations.
• Deliver webinars and training sessions to support successful program implementation.

Program Monitoring & Reporting

• Monitor eligibility, enrollment, and operational reports.
• Analyze trends, performance metrics, and stakeholder feedback.
• Prepare status updates and recommendations for leadership.
• Support data-driven decision-making and program enhancements.

Systems & Process Improvement

• Utilize management information systems to support daily program operations.
• Identify opportunities to improve workflows, efficiency, and participant experience.
• Provide recommendations for system enhancements and streamlined business processes.

Additional Duties

• Participate in special projects and initiatives as needed to support the evolving priorities of the Office of Health Insurance Programs (OHIP).

Preferred Qualifications

Candidates with experience in the following areas are strongly encouraged to apply:

• Medicaid programs and healthcare policy
• Home and Community Based Services (HCBS)
• Children's Waiver programs
• Children's Health Home services
• Care coordination or case management
• Pediatric healthcare, behavioral health, or developmental disabilities
• Foster care and child welfare systems
• Program eligibility determination and enrollment processes
• Policy analysis, training development, and stakeholder engagement

Desired Knowledge & Skills

• Strong interpersonal and relationship-building skills
• Excellent communication and presentation abilities
• Critical thinking and problem-solving skills
• Sound decision-making and organizational abilities
• Ability to manage multiple priorities and deadlines
• Experience analyzing reports, data, and operational processes
• Proficiency with Microsoft Office and other business applications
• Ability to work independently and collaboratively in a hybrid environment

Minimum Qualifications

• Eight (8) years of professional experience

Benefits

SSO offers a comprehensive benefits package designed to support your health, well-being, and financial future, including:

• Medical, Dental, and Vision Insurance
• 401(k) with Discretionary Employer Match
• Generous Paid Time Off and Paid Holidays
• Flexible Spending Accounts (FSA)
• Employee Assistance Program (EAP)
• Employee Discounts and Wellness Perks