Healthcare Data Specialist - Complaints Unit

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Healthcare Data Specialist 1 in Albany, NY

Division of Health Plan Contracting & Oversight (DHPCO) Item 1347

Managed Long Term Care (MLTC) Complaints Unit

Summary:
The person in this position will assist Bureau leadership and staff in the Office of Health Insurance Programs (OHIP), Division of Health Plan and Contract Oversight in a broad range of planning, implementation, reporting and evaluation activities within the Division of Health Plan Contracting and Oversight’s Bureau of Consumer Service’s Managed Long Term Care Complaints Unit.

Additional duties include:

• Research and respond to a wide range of inquiries from consumers, medical providers, plans, and other stakeholders
• Answer hotline calls, respond to queries submitted via email and other sources
• Contribute to the clarification of policies and procedures which may include marketing, enrollment, grievances and appeals, provider/plan education, and quality monitoring (metrics and compliance).
• Use digital software system to create, organize and track information related to cases.
• Participate in plan compliance survey and focused-review activities, as appropriate.
• Coordinate with other departments to improve reporting and enrollment processes.
• Other activities as may be deemed necessary in response to the changing needs of the Division.

Basic Qualifications:

• 2 years of managing OR administering OR reporting on data

Desired Characteristics:

• Associate degree (Bachelor’s preferred) in business, management, health care, public administration, or closely related field.
• A minimum of two (2) years of professional experience in a health care program that: reimburses for health care services; provides health care services directly; provides health care regulatory oversight: performs quality assurance and interpretation/application of standards of health care; manages health care utilization or conducts health care coordination activities.
• Strong analytical, research and communication (both written and verbal) skills.
• The ability to work independently in conducting research to support DOH policy
• The ability to function in a team environment.
• The ability to think creatively, strategically, and use investigative skills.
• The ability to de-escalate conflict using strength based language
• Preferred: Experience or knowledge of NYS public health insurance programs (e.g., Medicaid, Managed Long Term Care, CHPlus or Health Benefit Exchange.

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.

Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship including H-1B sponsorship) by SSO. Under the federal laws relating to the F-1 STEM EAD program, SSO may be able to support a STEM EAD extension application at the sole discretion of your Designated School Official. This does not guarantee that any STEM EAD extension application will be approved.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E-Verify participant.