Senior Health Care Management Systems Analyst (NY HELPS) - 87303

About the role

Within the Office of Health Insurance Program's Division of Health Plan Contracting and Oversight, in the Bureau of Managed Care Fiscal Oversight, the Senior Health Care Management Systems Analyst G-18 position will be assigned to the Medicaid Encounter Data Systems (MEDS) Compliance Unit and will play a vital role in the creation and review of Medicaid Encounter Data reporting, compliance and outreach activities to ensure Managed Care Organizations (MCO’s) 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 MCO’s.
• Evaluate timeliness and accuracy of MCO financial reports submitted by MCOs 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 skills and analytical skills, ability to solve problems independently. Professional work experience and/or education in healthcare and trend analyses.

Additional Comments: 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

• 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