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Senior Healthcare Program Specialist - DHPCO - Item 1070

Department: Division of Health Plan Contracting and Oversight (DHPCO)
Location: Albany, NY

Senior Healthcare Program Specialist  - DHPCO - Item 1070

GENERAL RESPONSIBILITIES: 

This individual will assist senior staff in the New York State Department of Health, Office of Health Insurance Programs (OHIP), Division of Health Plan Contracting and Oversight, Bureau of Consumer Services in implementing and evaluating health reform initiatives with a primary focus on analysis and reporting associated with the transition of vulnerable populations into managed care. 

DUTIES : 

  •   Provide data analysis for the development of information and insight to support the Bureauís complaint investigations as well as itís call intake functions.
  •   Requesting, gathering, combining and reporting on data coming from twenty or so MCOs on a quarterly basis in order to meet CMS reporting requirements.
  •   Research and analyze MCO business process data to prevent/ensure appropriate health care services and benefits are provided as defined under NYS regulations and contract requirements.
  •   Provide assistance with the design, implementation and maintenance of application programs and databases to support program operations and decision making.
  •   Provide research into MCO business processes to identify operational deficiencies or systemic problems associated with enrollee management and provider billing.
  •   Assist with onsite MCO business process reviews related to the identification and implementation of corrective actions for consumer service and benefit delivery problems and provider payment in-accuracies.
  •   Draft a wide range of documents which may include status reports, job aids and guidance documents.
  •   Other activities as may be deemed necessary in response to the changing needs of the Division

QUALIFICATIONS :  

  •   Strong analytical and communication (both written and oral) skills with the ability to present data and findings to interested parties with varying backgrounds.
  •   The demonstrated ability to think creatively and strategically.
  •   Excellent organizational skills with the ability to prioritize multiple assignments.
  •   The ability to work independently, as well as in a team environment.
  •   Proficient in the use of standard office technology and basic Microsoft Office applications including Word, Excel, Access, and PowerPoint.
  •   Ability to function in a multi task environment.
  •   The ability to travel within NYS as needed.

EDUCATION & EXPERIENCE :  

  •  Bachelorís degree required with 5 years of experience. Coursework to include: informatics, statistics, data analysis, data management or related field, required.
  •  Experience in health care and/or business analytics, preferred.
  •  Advanced skills in Excel and Access, preferred.
  • Managed care, healthcare administration and consumer service experience, preferred.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. VEVRAA Federal Contractor.  

Staffing Solutions Organization LLC is an e-Verify participant.

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