Eligibility Program Manager ; NY HELPS

Overview

This Eligibility Program Manager 2 position will oversee the administration of the Assistor Program in the Bureau of Consumer Assistance and Training within the Division of Eligibility and Marketplace Integration. This bureau provides operational administration of New York’s application assistor programs available through NY State of Health and at local Departments of Social Services. This includes over 350 agencies and 6,000 assistors who provide application assistance through NY State of Health to consumers.

It also has oversight of the Navigator, Facilitated Enrollment for Aged, Blind and Disabled and Medicare Outreach and the Consumer Health Advocate Programs.

This position will support the Bureau in all operations, including providing account setup and maintenance for assistors through NY State of Health and providing technical assistance for eligibility and enrollment concerns submitted by these agencies. The incumbent will be responsible for a team which will investigate and resolve issues related to applications completed by Application Assistors. This position will oversee the required training of assistors with a training vendor and ensure the timely development and delivery of annual recertification training for assistors.

The position will also direct Bureau staff in oversight of the training contract for Local Departments of Social Services.

Oversee the Assistor Program administration within the Bureau of Consumer Assistance and Training. Manage account setup and maintenance for NY State of Health assistors and provide technical assistance for eligibility and enrollment issues. Lead a team responsible for investigating and resolving issues in applications completed by Application Assistors. Oversee required training of assistors with a training vendor and ensure timely development and delivery of annual recertification training.

Direct Bureau staff in oversight of the training contract for Local Departments of Social Services.

Minimum Qualifications

Reassignment:
Current NYS Department of Health (DOH) employee with permanent or contingent permanent status as an Eligibility Program Manager 2, G-29.

Permanent Transfer Candidates

Current NYS employee with one year of permanent or contingent permanent competitive service in a title Grade 27 or above eligible for transfer to Eligibility Program Manager 2 under Section 70.1 or 52.6 of the Civil Service Law. The transfer cannot be a second consecutive transfer resulting in an advancement of more than two salary grades.

Open to the Public:
This title is part of the New York Hiring for Emergency Limited Placement Statewide program (NY HELPS). For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, if the candidate meets the below NY HELPS minimum qualifications.

NY HELPS Non-Competitive Minimum Qualifications

Nine years of professional experience*, three years of which must have included second-level supervision of professional staff, performing one or more of the following seven activities
* in a program with one or more of the following functions

• Overseeing and directing staff in determining eligibility for a health insurance program or consumer assisted program in which financial eligibility criteria must be met.
• Overseeing and directing staff in performing utilization review, including prepayment or post-payment review of requested health care services, prior approval or authorization activities, adjudication or pricing of claims for payment, or analysis of patterns of health care.
• Overseeing and directing staff in developing mechanisms for the reimbursement and financing of health care services, including rate-setting or approval, capitation reimbursement methodologies, fee schedule development, coding constructs for medical goods and services, or application and processing of reimbursement methodologies.
• Administering and overseeing staff responsible for day to day program operations for budgeting, staffing, or program planning.
• Overseeing and directing staff in inspecting, assessing, or monitoring health insurance programs or health care facilities for certification, licensure, or adherence to laws, rules, regulations, and policies.
• Overseeing and directing staff in planning, designing, developing, researching, or evaluating proposals to establish or refine health related programs, with responsibility for interpreting legislation or regulations, defining and describing target populations and local demographics, grant and proposal writing, or developing, reviewing, and evaluating contracts.
• Administering and overseeing staff responsible for performing quality assurance activities such as ensuring compliance with laws, rules, regulations, and policies, as it pertains to activities 1 through 6.
• A Bachelor's Degree can substitute for four years of experience; a Master's Degree can substitute for five years of experience.

Preferred Qualifications

Preferred candidates will have…