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Health Care Financing Program Manager 1 (NY HELPS) - 61604

New York State Department of Health · Albany, NY · 1 wk ago
HybridAccountingFull-time

About the Role

The Office of Health Insurance Programs (OHIP) administers New York State’s Medicaid program, a critical component of the state’s health care expenditures. Within OHIP, the Division of Finance and Rate Setting (DFRS) oversees Medicaid rate setting, budget management, and the Medicaid Global Spending Cap. The Bureau of Nursing Home and Long Term Care Rate Setting, part of DFRS, manages rate setting, cost analysis, and reimbursement policies for nursing homes and long-term care facilities. The Health Care Finance Program Manager 1 will serve as an Assistant Bureau Director, overseeing Medicaid fee-for-service rate setting and financial operations for home care, hospice, foster care, and other long-term care programs.

Responsibilities

  • Direct and oversee the development, review, approval, and implementation of annual, supplemental, and special Medicaid fee-for-service rate packages for assigned programs.
  • Oversee the collection, validation, reconciliation, and analysis of cost reports, provider financial submissions, utilization data, and other information used in rate setting.
  • Direct the review and resolution of complex rate appeals, audit findings, payment disputes, and litigation-related matters.
  • Evaluate the fiscal, operational, and provider impacts of proposed reimbursement methodologies, rate changes, and programmatic reforms.
  • Coordinate with internal and external stakeholders, including rate-setting units, fiscal management staff, legal affairs, program offices, contractors, auditors, providers, and federal partners.
  • Represent the Bureau in meetings with executive staff, Department leadership, the Division of the Budget, and other stakeholders.
  • Direct the preparation of executive-level briefings, fiscal analyses, policy recommendations, and presentation materials.
  • Establish and monitor policies, procedures, production schedules, internal controls, and quality assurance standards for assigned programs.
  • Ensure compliance with State and federal laws, regulations, and Medicaid requirements.
  • Supervise at least two G-27 team leads, including assigning work, monitoring performance, and ensuring timely completion of assignments.
  • Provide managerial direction for Bureau functions, including rate calculation, audit review, fiscal tracking, and documentation maintenance.
  • Monitor program performance, staffing capacity, and emerging risks, recommending corrective actions to the Bureau Director.
  • Advise leadership on rate-setting priorities, policy issues, staffing needs, and program changes.

Qualifications

Minimum Qualifications:

  • Permanent Transfer Candidates: Current NYS Department of Health employee with permanent status as a Health Care Financing Program Manager 1, or eligible for transfer under Section 52.6 of the Civil Service Law.
  • Non-Competitive Candidates via NY HELPS Program: Bachelor’s degree and four years of professional finance experience, including one year managing health care financing (e.g., reimbursement, fiscal analysis, policy development) with policy recommendation and supervisory oversight responsibilities. Juris Doctor or advanced degree can substitute for one year of specialized experience.

Preferred Qualifications:

  • Strong critical thinking and analytical skills.
  • Significant experience with Microsoft Excel.
  • Knowledge of Medicaid policy, rate setting, and trend analysis.
  • Familiarity with the NYS Medicaid program and ability to collaborate with State Agencies, the Division of Budget, and CMS.

Additional Comments

Microsoft Excel proficiency is required. Candidates must clearly demonstrate how they meet minimum qualifications. This position is part of the NYS HELPS program and does not require an examination. We offer a comprehensive benefits package, including health care, retirement, and work-life balance options. The NYS Department of Health is committed to health equity and eliminating disparities. Reasonable accommodations are available upon request. The Department does not participate in E-Verify or sponsor visas.

Benefits

  • Holiday & Paid Time Off
  • Public Service Loan Forgiveness (PSLF)
  • Pension from NYS Employees’ Retirement System
  • Shift & Geographic pay differentials
  • Affordable Health Care options
  • Family dental and vision benefits
  • NYS Deferred Compensation plan
  • Access to NY 529 and NY ABLE College Savings Programs
  • U.S. Savings Bonds

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