Duties 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.
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:
- 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
- And many more...
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
[email protected] 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.
