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Review Vacancy
Date Posted 09/14/26
Applications Due09/28/26
Vacancy ID223812
NY HELPNo
AgencyHealth, Department of
TitleMedical Assistance Specialist 1 - 88223
Occupational CategoryOther Professional Careers
Salary Grade18
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $66951 to $85138 Annually
Employment Type Full-Time
Appointment Type Contingent Permanent
Jurisdictional Class Competitive Class
Travel Percentage 5%
Workweek Mon-Fri
Hours Per Week 37.5
Workday
From 8 AM
To 5 PM
Flextime allowed? No
Mandatory overtime? No
Compressed workweek allowed? No
Telecommuting allowed? Yes
County Albany
Street Address Office of Health Insurance Programs/Division of Health Plan Contracting and Oversight/Bureau of Managed Care Certification and Surveillance
99 Washington Avenue
City Albany
StateNY
Zip Code12210
Duties Description In the Office of Health Insurance Programs Division of Health Care Plan Contracting & Oversight, within the Bureau of Managed Care Certification and Surveillance, the incumbent will assist in ongoing certification and surveillance of Managed Care Organizations (MCOs) to ensure compliance with Public Health Law Articles 44 and 49 as well as 10 NYCRR Part 98 and Model Contracts.
Specific duties and responsibilities may include but are not limited to:
Complete activities related to Utilization Review (UR) including review of UR applications.
Complete surveillance activities of Managed Care Organizations to ensure compliance with DOH and federal laws, rules, and regulations.
Analyze state and federal legislation related to managed care and review for impact on existing program operations.
Draft reports, policies, and procedures for internal and external review and distribution.
Develop and maintain document library for policies, procedures, and standard guidelines.
Assist in interpreting and clarifying policy guidelines as well as identifying critical issues for bureau and division leadership.
Draft, review, and update training and guidance documents.
Assist in managing survey team shared mailboxes.
Minimum Qualifications Reassignment: Current NYS Department of Health (DOH) employee with permanent or contingent-permanent status as a Medical Assistance Specialist 1, G-18.
Transfer: Current NYS employee with one year or more of permanent or contingent-permanent, competitive service in a title eligible to transfer under Section 52.6 or Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 1, G-18.
NY HELPS: Six years of experience developing public or private health related policy; analyzing AND interpreting public or private health related policy to assist consumers; determining or reviewing financial eligibility for healthcare or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations; establishing mechanisms for the reimbursement and financing of health care services, including rate-setting, development of capitation reimbursement methodologies, and development of fee schedules; performing utilization review of requests for medical treatment including prior approval or authorization activities, adjudication of claims for payment and/or provider credentialing; AND/OR conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.
Substitution: An associate degree can substitute for two years of specialized experience; a bachelor's degree can substitute for four years of experience; a master's degree in a related field can substitute for five years of experience; and a doctorate in a related field can substitute for six years of experience.
Preferred Qualifications: Knowledge of Medicaid Program, Managed Care Delivery Models, Public Health Law and Regulation with experience in interpretation of governing laws, regulations, or policy
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.
We offer a work-life balance and a generous benefits package, worth 65% of salary, including:
The NYS Department of Health is committed to making New York a safer, healthier, and more equitable place to live. Understanding health equity, social determinants of health and health disparities is critical to accomplish our goal of eliminating health disparities. For more information on the NYS Department of Health's Mission, Vision, Values and Strategic Plan, please visit: https://health.ny.gov/commissioner/index.htm
If you require reasonable accommodation to complete a job application, a job interview or to otherwise participate in the hiring process, please contact by phone 518-486-1812 or email doh.sm.Reasonable.Accommodation@health.ny.gov to make a request.
The NYS Department of Health does not participate in E-Verify and does not sponsor visa applications.
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.
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resources Management Group, EW/MAS1/88223
Telephone 518-486-1812
Fax 518-473-3395
Email Address resume@health.ny.gov
Address
Street Corning Tower, Empire State Plaza, Room 2217
City Albany
State NY
Zip Code 12237
Notes on ApplyingPlease submit your resume and cover letter as one (1) document, preferably in PDF format, by email to resume@health.ny.gov, with Reference EW/MAS1/88223 included in the subject line or by mail to Human Resources Management Group, EW/MAS1/88223, Rm 2217, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0012, or by fax to (518) 473-3395. Failure to include the required information may result in your resume not being considered for this position.
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| Location | Albany, NY |
| Salary | $66,951–$85,138 Per Year |
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