Senior Health Care Management Systems Analyst (NY HELPS)

Job Description

The Senior Health Care Management Systems Analyst G-18 position, in the Office of Health Insurance Program's Division of Health Plan Contracting and Oversight, will be assigned to the Bureau of Managed Care Fiscal Oversight in 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.
- Collaborate with program staff to develop program analysis, evaluate the effectiveness of the alternatives, and assess data output to ensure it supports the analytic needs of the agency.
- Responsible for the creation of monthly validation and compliance reports used to determine adherence to data accuracy, review data completeness and timely submission and monitor the enforcement and adherence to the 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 the MCOs to successfully verify financial condition, analyze fiscal operations and 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 to develop policy and procedure briefs, letters, memoranda and other written materials on specific MEDS issues.

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.

Requirements

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.