MEDICAID CONSULTANT

About the role

The Home Care Services Program (HCSP) is recruiting for one Principal Administrative Associate II to function as a Medicaid Consultant. This role involves interpreting Medicaid policies and procedures for individuals applying for or receiving services through various long-term care programs, ensuring compliance with Federal, State, and City guidelines.

Responsibilities

• Interpret Medicaid policies and procedures for assigned cases for individuals applying for or in receipt of services through one of the CASA offices, the Managed Long-Term Care (MLTC) Program, the Long Term Home Health Care Program (Lombardi), Care At Home (CAH), the Assisted Living Program (ALP), and the Field Services/Homebound Unit to ensure that cases are processed in compliance with Federal, State, and City Guidelines.
• Supervise and distribute work schedules/assignments to the Medicaid Eligibility Team Supervisors, provide a timetable for efficient completion of work and ensure adequate coverage during the hours of operation.
• Provide second-level sign-off approval for all adverse case actions to ensure that the cases are properly documented, and that the appropriate processing protocols are applied.
• Conduct random review of completed cases to determine if the proper decision was made based on the documentation provided.
• Conduct meetings with Medicaid Eligibility Team Supervisors to advise on problems identified in their teams and provide written reports of meetings indicating problems found, resolution(s) initiated, and recommendations for corrective training.
• Conduct training sessions to provide Medicaid Eligibility Team Supervisors and/or Eligibility Specialists with correction and feedback based on the unit review to reduce or eliminate Quality Control errors.
• Review computer error reports, check for repetition of specific errors and follow up to determine reason for the errors.
• Review the control process to ensure that it is operating with maximum efficiency.
• Aid Medicaid Eligibility Team Supervisors and/or Eligibility Specialists on cases requiring resolution for high-priority actions such as Tape Match, Fair Hearing and Quality Assurance issues.

Qualifications

• A baccalaureate degree from an accredited college and two years of satisfactory full-time progressively responsible clerical/administrative experience, one year of which must have been in an administrative capacity or supervising staff performing clerical/administrative work of more than moderate difficulty;
• Or an associate degree or 60 semester credits from an accredited college and three years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience described above;
• Or a four-year high school diploma or its educational equivalent approved by a state's department of education or a recognized accrediting organization and four years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience as described above;
• Or education and/or experience equivalent to the above. However, all candidates must possess the one year of administrative or supervisory experience as described above. Education above the high school level may be substituted for the general clerical/administrative experience (but not for the one year of administrative or supervisory experience) at a rate of 30 semester credits from an accredited college for 6 months of experience up to a maximum of 3 years.

Preferred skills

• Medicaid Knowledge
• Strong Supervisory and Interpersonal Skills
• Excellent Oral and Written Communication
• Proficient in Word and Excel
• Strong knowledge of City Time and Leave regulations
• Ability to accurately interpret and apply Timekeeping and leave policies and procedures

Hours/Shift: 9am - 5pm (FLEX)

Civil Service Title: Principal Administrative Associate - 10124

Residency Requirement: New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.