Senior Health Care Management Systems Analyst (NY HELPS) - 80476

About the role

The Senior Health Care Management Systems Analyst (G-18) will be assigned to the Bureau of Managed Care Fiscal Oversight in the Medicaid Encounter Data Systems (MEDS) Compliance Unit. This role plays a vital role in the creation and review of Medicaid Encounter Data reporting, compliance, and outreach activities to ensure Managed Care Organizations (MCOs) meet mandated program and compliance standards.

Responsibilities

• Collaborate with program staff to develop program analysis, evaluate the effectiveness of alternatives, and assess data output to ensure it supports the analytic needs of the agency.
• Create monthly validation and compliance reports to determine adherence to data accuracy, review data completeness and timely submission, and monitor enforcement and adherence to submission and reporting guidelines.
• Research, analyze, and evaluate encounter data submitted by Managed Care Organizations.
• Review validation and compliance report findings and prepare comprehensive reports of analysis for distribution and outreach to MCOs.
• Evaluate timeliness and accuracy of MCO financial reports to verify financial condition, analyze fiscal operations, and ensure compliance with fiscal reporting requirements, reserve and escrow fund requirements pursuant to related laws, regulations, and internal Bureau policies.
• Maintain and develop SAS and SQL coding to extract data from MDW and OHIP Data-mart as necessary to prepare statistical reports, policy and procedure briefs, letters, memoranda, and other written materials on specific MEDS issues.

Qualifications

Minimum 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
  • A 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, NS, or Health Care Management Systems Analyst, Trainee 2, NS.
• 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.

Substitution: 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.

When reviewing qualifications, omissions and vagueness cannot be interpreted in the candidate’s favor. Candidates are responsible for providing accurate and clear descriptions of their experience demonstrating how they meet the minimum qualifications.

This position is part of the NYS HELPS program. No examination is required. This position may require travel throughout New York State, including overnights to areas not served by public transportation.

Benefits

The position offers a work-life balance and a generous benefits package worth 65% of salary, including:

• 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

Pay

For new State employees appointed to graded positions, the annual salary is the hiring rate of the position (beginning of the salary range). 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.