What are the responsibilities and job description for the Health Systems Specialist 1/Trainee 2/Trainee 1 - 80151 position at State of New York - Health, Department of?
Duties Description In the Office of Health Insurance Programs's Division of Health Plan Contracting and Oversight, within the Bureau of Managed Long Term Care, the Health Systems Specialist 1 position will work in the Bureau's Systems Unit. Responsibilities will include but not be limited to: 1. Learning the Department's multiple eligibility systems and assisting in reviewing eligibility requirements. Acting as primary contact in processing of MLTC and MAP enrollments and disenrollments in the eligibility systems. 2. Focusing on aligning with federal requirements for PACE Plans. Acting as a primary contact in processing of PACE enrollments and disenrollments in the eligibility systems. 3. Solutioning coverage code errors and eligibility stacking errors with Local Districts of Social Services (LDSS) and Department stakeholders. 4. Cross training in all major System Unit functions including processing hospice requests; assisting with systems needs for acquisitions/mergers, new plans, and plan closures as needed, etc. 5. Assisting as a back-up for Coordination of Benefits Agreements (COBA) and Fair Hearing processes.
Minimum Qualifications Permanent Transfer:
Current New York State employee with one year or more of permanent or contingent permanent, competitive service in a Health Systems Specialist 1 (G18) position OR a NYS employee in a position G16 or higher and eligible for transfer under Section 70.1 or Section 70.4 of the Civil Service Law.
Non-Competitive via NY HELPS:
Health Systems Specialist 1: Six years of experience performing or implementing medical or programmatic surveillance, audit, compliance, quality assurance, or regulatory activities for patients or a health care delivery system for a health care facility or health related organization.
Health Systems Specialist Trainee 2: Five years of experience performing or implementing medical or programmatic surveillance, audit, compliance, quality assurance, or regulatory activities for patients or a health care delivery system for a health care facility or health related organization.
Health Systems Specialist Trainee 1: Four years of experience performing or implementing medical or programmatic surveillance, audit, compliance, quality assurance, or regulatory activities for patients or a health care delivery system for a health care facility or health related organization.
Substitution:
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.
Preferred Qualifications: Knowledge of NYS Medicaid program, eligibility and systems experience, and familiarity with Managed Long Term Care benefits.
This position is part of the NYS HELPS program. No examination is required.
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..."
The NYS Department of Health is committed to making New York a safer, healthier, and more equitable place to live. Understanding health equity, social determinants of health and health disparities is critical to accomplish our goal of eliminating health disparities. For more information on the NYS Department of Health’s Mission, Vision, Values and Strategic Plan, please visit: https://health.ny.gov/commissioner/index.htm
If you require reasonable accommodation to complete a job application, a job interview or to otherwise participate in the hiring process, please contact by phone 518-486-1812 or email doh.sm.Reasonable.Accommodation@health.ny.gov to make a request.
The NYS Department of Health does not participate in E-Verify and does not sponsor visa applications.
For new State employees appointed to graded positions, the annual salary is the hiring rate of the position (beginning of the salary range). 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.
Benefits:
Health Insurance, Vacation & Paid Time Off, Pension PlanSalary : $56,183 - $88,970