New York State Department of Health

Description

Duties Description

This position is in the Division of Medical & Dental Directors. The incumbent will be responsible to review and advise on Medicaid Policy, evaluate the evidence base for new technologies, coding and other state policies for coverage by Medicaid, review prior approval requests and appeals related to specific benefits including input on pended medical claims and physician-administered drugs, and consult as needed on issues across the program requiring clinical input. The incumbent will participate in both internal and external committees and workgroups and liaison with Medicaid enrolled clinicians and the clinical staff in the Medicaid Managed Care Plans. The incumbent will be a key stakeholder in advancing the Medicaid Program and interacting with the Division Medical Director, other medical and dental directors, and staff within the Office of Health Insurance Programs. The incumbent will also be responsible to participate in Divisional stakeholder engagement activities related to the Medicaid program, support health care transformation initiatives, and promote policies that address health equity.

Minimal travel required. This is an Albany-based position.

Qualifications

Minimum Qualifications

Possession of a license to practice medicine in New York State, board-eligible or board certification in a medical specialty, and one year of experience in a clinical, hospital, or patient care setting.

Preferred Qualifications: Demonstrated experience with Medicaid and/or Managed Care programs; Demonstrated knowledge of Alternative Payment Models and value-based care initiatives; Demonstrated experience with medical coding and healthcare reimbursement methodologies; Demonstrated experience analyzing claims data and healthcare utilization trends; Demonstrated ability to use data to inform program planning, policy development, and operational decision-making.

Additional Comments

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 doh.sm.reasonable.accommodation@health.ny.gov to make a request.

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 (beginning of the Salary Range) of the position. 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.