Source: New York State Jobs · Bespree is not the employer.
The Health Program Director 1 (HPD1) will serve as the Director for the Bureau of Provider Enrollment (BPE), responsible for enrolling, maintaining, and revalidating more than 240,000 Medicaid providers (e.g., over 200,000 individual providers, more than 10,000 businesses, 11,000 practitioner groups, and 10,000 institutional providers). Proper enrollment is critical for providers to get reimbursed for essential care delivered to NYS Medicaid Members and to mitigate fraud, waste, and abuse within the Medicaid program. Core functions of the Bureau include all enrollment-related transactions, training and quality assurance, provider relationship management, program integrity, answering audits, and executing required data reporting. The Bureau partners with many different programs within OHIP, including but not limited to NYRx, dental, health access, maternal & child health, laboratory, and durable medical equipment policy teams. In addtion BPE is the lead Bureau to Centers for Medicare and Medicaid Services (CMS) enrollment division, to NYS agencies including but not limited to Office for Alcohol and Substance Abuse Services (OASAS), Office of Mental Health (OMH), and Office for People with Developmental Disabilities (OPWDD). BPE also works together with the Office of the Medicaid Inspector General (OMIG) on fraud, waste, and abuse referrals as well as enrollment appeals and sanctions.
In 2025, BPE launched the first ever electronic Provider Services Portal (PSP) for enrollment, replaceing a paper process. In April of 2026, CMS announced an initiative to revalidate all Medicaid providers within a two-year time period. The Bureau has developed a robust revalidation plan to accomplish the requirement.
Eleven years of professional level work experience, two of which must have included managerial, decision-making, and/or oversight of a major health-related program or in the direction of a major administrative function of a large health related organization. A bachelor’s degree may be substituted for four years of the general professional experience; a master’s degree in an appropriate field may be substituted for an additional year of that experience.
Preferred Qualifications: The candidate should have demonstrated experience working with the New York State Medicaid program. We are looking for a strong leader with a track record of advancing programs by articulating goals, planning, and implementing processes to achieve those goals. The candidate should have experience interpreting and implementing federal or state legislation, as well as drafting, revising, and implementing new or modifying New York State regulations. The preferred candidate should have a track record of successfully engaging with a range of stakeholders in interagency and state/federal settings to implement programs or policies. The candidate should have experience setting standards, developing quality protocols for processes, and have strong analytical, written, and oral communication skills.
New York State agencies, departments, and public authorities provide services across healthcare, engineering, administration, public safety, the trades, and other areas.
Source: New York State Jobs · Bespree is not the employer.
The Health Program Director 1 (HPD1) will serve as the Director for the Bureau of Provider Enrollment (BPE), responsible for enrolling, maintaining, and revalidating more than 240,000 Medicaid providers (e.g., over 200,000 individual providers, more than 10,000 businesses, 11,000 practitioner groups, and 10,000 institutional providers). Proper enrollment is critical for providers to get reimbursed for essential care delivered to NYS Medicaid Members and to mitigate fraud, waste, and abuse within the Medicaid program. Core functions of the Bureau include all enrollment-related transactions, training and quality assurance, provider relationship management, program integrity, answering audits, and executing required data reporting. The Bureau partners with many different programs within OHIP, including but not limited to NYRx, dental, health access, maternal & child health, laboratory, and durable medical equipment policy teams. In addtion BPE is the lead Bureau to Centers for Medicare and Medicaid Services (CMS) enrollment division, to NYS agencies including but not limited to Office for Alcohol and Substance Abuse Services (OASAS), Office of Mental Health (OMH), and Office for People with Developmental Disabilities (OPWDD). BPE also works together with the Office of the Medicaid Inspector General (OMIG) on fraud, waste, and abuse referrals as well as enrollment appeals and sanctions.
In 2025, BPE launched the first ever electronic Provider Services Portal (PSP) for enrollment, replaceing a paper process. In April of 2026, CMS announced an initiative to revalidate all Medicaid providers within a two-year time period. The Bureau has developed a robust revalidation plan to accomplish the requirement.
Eleven years of professional level work experience, two of which must have included managerial, decision-making, and/or oversight of a major health-related program or in the direction of a major administrative function of a large health related organization. A bachelor’s degree may be substituted for four years of the general professional experience; a master’s degree in an appropriate field may be substituted for an additional year of that experience.
Preferred Qualifications: The candidate should have demonstrated experience working with the New York State Medicaid program. We are looking for a strong leader with a track record of advancing programs by articulating goals, planning, and implementing processes to achieve those goals. The candidate should have experience interpreting and implementing federal or state legislation, as well as drafting, revising, and implementing new or modifying New York State regulations. The preferred candidate should have a track record of successfully engaging with a range of stakeholders in interagency and state/federal settings to implement programs or policies. The candidate should have experience setting standards, developing quality protocols for processes, and have strong analytical, written, and oral communication skills.
New York State agencies, departments, and public authorities provide services across healthcare, engineering, administration, public safety, the trades, and other areas.