NY HELP Yes

Agency Health, Department of

Title Health Systems Specialist 2 (PT) (HELP) - 23628

Occupational Category Health Care, Human/Social Services

Salary Grade 20

Bargaining Unit PS&T - Professional, Scientific, and Technical (PEF)

Salary Range From $72032 to $91381 Annually

Employment Type Full-Time

Appointment Type Contingent Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 9 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

County Albany

Street Address Office of Health Insurance Programs/Division of Medical and Dental Directors/OHIP

One Commerce Plaza

City Albany

State NY

Zip Code 12260

Minimum Qualifications COMPETITIVE MINIMUM QUALIFICATIONS:Permanent Transfer Candidates: Current DOH employee with permanent status as a Health Systems Specialist 2 (PT), G-20 OR Current New York State employee with one year of permanent or contingent-permanent service in a position G-18 or higher, and eligible for 70.4 transfer (must pass exam by meeting provisional qualifications below).NON-COMPETITIVE QUALIFICATIONS:Possession of New York State license and current registration as a physical therapist, and two years of experience in the following areas: providing clinical services in a licensed healthcare facility or program, or utilizing clinical knowledge in the review or oversight of clinical services for reimbursement or quality assurance purposes.Preferred Qualifications: Experience in all facets of PT/OT including working with all age groups and evaluating/treating patients in all settings who require a wide range of durable medical equipment; versed in use of the equipment, pieces and parts that make up the equipment, and the appropriateness of equipment for a wide range disease processes; excellent writing skills to communicate effectively with physicians and vendors in the community, and in preparing documentation packages that are submitted through the Fair Hearing process for denial of any Medicaid service.

Duties Description The Health Systems Specialist 2 (PT) (HSS2) licensed Physical Therapist (PT), grade 20, will be assigned to the Bureau of Medical Review Prior Approval Unit. The HSS2 will be responsible for reviewing prior approval requests for durable medical equipment (DME) to determine if the service falls within the scope of coverage of the Medicaid program and to determine if the service is appropriate for a particular patient’s medical needs. This function requires the use of professional judgment in the examination of the proposed equipment purchase or rental for the patient along with written and telephone communication with outside stakeholders. The HSS2 will utilize national standards for procedure and diagnosis coding, review appropriate combinations of medical services, and identify patterns to prevent fraud and abuse. The HSS2 will assist in training staff as a DME subject matter expert, assist with reviewing and making coverage determinations of new technologies, and provide technical assistance to providers. They will ensure that all eligibility and regulatory requirements of the Medicaid program are met during the process. The HSS2 will supervise other prior approval state and contract staff.

Additional Comments 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...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. 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

Some positions may require additional credentials or a background check to verify your identity.

Name Human Resources Management Group, EM/HSS2(PT)/23628

Telephone 518-486-1812

Fax 518-473-3395

Email Address resume@health.ny.gov

Address

Street RM 2217, Corning Tower Building, ESP,

City Albany

State NY

Zip Code 12237

Notes on Applying Please submit your resume and cover letter as one (1) document, preferably in PDF format, by email to resume@health.ny.gov, with Reference EM/HSS2(PT)/23628 included in the subject line or by mail to Human Resources Management Group, EM/HSS2(PT)/23628, Rm 2217, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0012, or by fax to (518) 473-3395. Failure to include the required information may result in your resume not being considered for this position.