Senior Health Care Management Systems Analyst (NY HELPS) - 80464

This position is in the Office of Health Insurance Program's Division of Health Plan Contracting and Oversight, serving within the Bureau of Managed Care Fiscal Oversight in the Financial Report and Oversight Unit. The role focuses on reviewing Cost Reports and Medical Loss Ratio (MLR) Reports to ensure compliance and accuracy of Managed Care Organizations (MCOs) with mandated program regulations and standards.

Responsibilities

• Collaborate with BMCFO and Plan staff to develop program analysis, evaluate alternatives, and assess data output to support agency needs.
• Review quarterly financial reports for Medicaid Managed Care plans and Managed Long Term Care Plans.
• Update software to accommodate new benefits, programmatic changes, new premium groups, and assist plans with reporting questions.
• Develop and maintain MLR SFY Annual Reporting for Managed Care lines of business (Medicaid, HARP, HIV SNP, MLTC Partial, MAP, and PACE) by premium group, quarter, and region, including EP MLR and CHP MLR CY Annual Reporting.
• Create and maintain review tools for plan solvency, including calculations for Contingent Reverse Requirement, Escrow Requirement, Premium Income, Net Income Profit & Loss, and MLR Liability, along with multi-year trend analysis.
• Maintain and develop Excel spreadsheets to prepare statistical reports, policy briefs, letters, memoranda, and other written materials on financial reporting issues.

Qualifications

Permanent Transfer Candidates:

• Current New York State Department of Health employee with permanent or contingent-permanent, competitive status as a Senior Health Care Management Systems Analyst, SG-18, or
• Current New York State employee with one year of permanent or contingent-permanent, competitive service in a title eligible for transfer under Section 52.6, 70.1, or 70.4 of the NYS Civil Service Law to Senior Health Care Management Systems Analyst, SG-18, Health Care Management Systems Analyst, Trainee 1, or Health Care Management Systems Analyst, Trainee 2.

Non-Competitive Candidates (via NY HELPS Program):

• Senior Health Care Management Systems Analyst: A bachelor’s or higher degree and two years of professional experience in conducting public policy research and analysis in finance.
• Health Care Management Systems Analyst, Trainee 2: A bachelor’s degree and one year of professional experience in conducting public policy research and analysis in finance.
• Health Care Management Systems Analyst, Trainee 1: A bachelor’s or higher degree.

A Juris Doctor, master’s, or higher degree in a related field can substitute for one year of specialized experience.

Preferred Qualifications

• Critical thinking and analytical skills, with the ability to solve problems independently.
• Professional work experience and/or education in healthcare and trend analyses.

This position is part of the NYS HELPS program and does not require an examination. It may require travel throughout New York State, including overnights to areas not served by public transportation.

Benefits

• Generous benefits package worth 65% of salary.
• Holiday and paid time off.
• Public Service Loan Forgiveness (PSLF).
• Pension from the New York State Employees’ Retirement System.
• Shift and 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.