Eligibility Program Manager 1 (NY HELPS) - 79434

$103,784 - $127,830/Yr

Commonwealth Of Puerto Rico - Albany, NY

Full-time - Mid Level

Albany, NY

Justice, Public Order, and Safety Activities

About the position

The Eligibility Program Manager 1 (NY HELPS) will oversee the Medicaid and Child Health Plus Units within the Division of Eligibility and Marketplace Integration. This role involves developing and updating review methodologies to ensure compliance with state and federal regulations regarding recipient eligibility and enrollment processes. The manager will supervise staff, coordinate assignments, and prepare reports summarizing case review results.

Responsibilities

• Provide first and second level supervision to professional subordinate staff, coordinate staff assignments, set unit priorities and deadlines, monitor and evaluate staff performance, and resolve issues as necessary.
• Act as a subject matter expert (SME) in workgroups to query data systems and develop universes for sample cases, overseeing the query testing process.
• Develop trainings and review protocols specific to each review project, including designing standardized review worksheets.
• Work with other Department agencies to obtain payment system information for sample cases and verify Federal Medical Assistance Percentage (FMAP) claims.
• Prepare statistical and narrative reports summarizing case review results for management review and approval.
• Draft correspondence and liaise with CHPlus health plans, local social service districts, and NY State of Health staff regarding review results.
• Provide technical assistance to internal review staff and other stakeholders, assisting with root cause analyses and policy decisions.

Requirements

• A bachelor's degree and four years of professional experience, two years of which must have included second-level supervision of staff.
• Experience in public health insurance programs, including New York's Medicaid, Medicare, and/or Child Health Plus.

Nice-to-haves

• Excellent verbal and written communication skills.
• Strong analytical skills and attention to detail.
• Strong organizational skills.
• Proficiency in Microsoft Office (Word, Excel, Access).
• Ability to work independently and as part of a team, managing multiple priorities to meet deadlines.
• Experience using electronic data systems, such as eMedNY and NYSOH Back Office.

Benefits

• 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