Medicaid Eligibility Examiner 2 – 79265, 79194

The minimum qualifications required for this vacancy. Minimum Qualifications This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). HELPS Program titles may be filled via a noncompetitive

appointment. This means that you do not need to take an exam to qualify, but you do need to meet the minimum qualifications of the title.

If you are hired under the HELPS Program, you will be first be appointed as a temporary employee. In May 2024, if you are performing successfully in the position, your appointment will be changed from temporary to permanent non-competitive. Once you are in permanent status, your official probationary period will begin and you may take any promotion exam for which you are qualified.

At a future date (within one year of permanent appointment), employees hired under NY HELPS are expected to have their permanent non-competitive

employment status converted to permanent competitive status. You will not have to take an exam to gain permanent competitive status.

NON-COMPETITIVE MINIMUM QUALIFICATIONS:

Four years of full-time experience performing one or more of the following six activities, in a program with one or more of the following functions: reimburses for health care services; works with social services program areas; determines eligibility for a consumer assisted program in a hospital or other health care facility; provides health care regulatory oversight; or performs quality assurance and interpretation/application of standards of health care. Activities include: determining eligibility for a health care program in which financial eligibility criteria must be met; performing utilization review, including pre-payment or post-payment review of requested health care services, prior approval or authorization activities, adjudication or pricing of claims for payment; or analysis of patterns of health care; determining reimbursement and financing of health care services, including rate-setting or approval, establishing capitation reimbursement methodologies, assessing fee schedules, coding constructs for medical goods and services, or applying/processing of reimbursement methodologies; performing quality assurance activities such as ensuring compliance with laws, rules, regulations, and policies; inspecting, assessing, or monitoring health care programs or facilities for certification, licensure, or adherence to laws, rules, regulations, and policies; planning, designing, developing, researching, or evaluating proposals to establish or refine programs, with ongoing responsibility for interpreting legislation or regulations, defining and describing target populations and local demographics, grant and proposal writing, or developing, reviewing, and evaluating contracts.

College credit hours may substitute for up to two years of experience at the rate of 30 college credits equaling one year of experience.

COMPETITIVE MINIMUM QUALIFICATIONS:

Current NYS employee with one year or more of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner 2 (G14) or Medicaid Eligibility Examiner 2 (Spanish Language) (G14), OR a NYS employee with one year or more of permanent or contingent-permanent, competitive service in a position allocated to a salary grade 12or above and eligible for transfer under Section 70.1 of the Civil Service Law.

If three or fewer New York State Department of Health promotional candidates respond to this notice, the agency may, at its discretion, nominate a qualified employee for non-competitive promotion under the provisions of Section 52.7 of the Civil Service Law.

Preferred Qualifications: Preferred candidates will have professional experience in public health insurance programs, including New York’s Medicaid, Medicare and/or Child Health Plus. Preferred candidates will also have excellent verbal and written communication skills; strong analytical skills and attention to detail; strong organizational skills; proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team, and to manage multiple priorities in order to meet deadlines; and experience using electronic data systems, such as eMedNY and NYSOH Back Office. Supervisory experience is a plus.

The duties that the incumbent of the vacancy will be expected to perform. Duties Description The Medicaid Eligibility Examiner 2 (MEE 2) will work within the DEMI Bureau of Quality Management and Change Control.

Specific duties may include but are not limited to: providing supervision to lower level staff; fielding electronic referrals from the contact center; working with appropriate staff to resolve consumer issues; identifying and tracking changes to training materials and procedure documents; conducting quality (QA) reviews of work completed by the NY State of Health customer service center contractor using established QA procedures; and maintain cooperative working relationships with other units, division, departments, and agencies to facilitate the delivery of public health insurance.

Additional comments regarding the vacancy. Additional Comments 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…

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.

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

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

Read Full Description