Source: New York State Jobs · Bespree is not the employer.
The Medical Assistance Specialist 1 will work within the Eligibility Systems Modernization Group (ESMG) as part of a team responsible for implementing the Medicaid policy/legislative changes to the Rest of State (ROS) Welfare Management System (WMS); assisting in the development and testing of the Medicaid Eligibility and Client Management (MECM) system; executing User Acceptance Testing(UAT) for policy/legislative changes to NYSOH; the transition of populations out of WMS into NYSOH and MECM; provide project support where changes to NYSOH, eMedNY, and the MECM impact WMS interfaces; Production support including file transfers, Help Desk, defect analysis and remediation for MECM and ROS WMS; and the support of continuous improvement activities required to reduce risk and minimize the negative consequences of implementing business systems change.
The incumbent will be primarily responsible for work efforts for the Bureau of Upstate Eligibility Systems (UES) as part of the Testing team related to the implementation of rule changes in compliance with the federal HR1 (Big Beautiful Bill) legislation including, but not limited to:
Participates in development activities with staff and contractors, including meeting with stakeholders, to track system behavior and documentation.
Reviews system change requests to ensure systems adhere to applicable Program policies.
Collaborate with other departments and stakeholders to review system change documentation.
Drafts, reviews, and updates training and guidance documents, manuals, and
job aids.
Writes procedure manuals and documents process.
Develop and implement test plans, test cases, and test scripts based on information shared in joint application design sessions, functional and interface documentation, and other sources.
Develops test data and scenarios, tests systems functions in UAT, and documents the results.
Current New York State Department of Health employee with permanent or contingent-permanent status as a Medical Assistance Specialist 1, G-18, OR; Current New York State employee with one year or more of permanent or contingent-permanent, competitive service in a title eligible to transfer under Section 52.6 or Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 1, G-18.
Non-Competitive Qualifications via NY HELPS:
Six years of experience* developing public or private health related policy; analyzing AND interpreting public or private health related policy to assist consumers; determining or reviewing financial eligibility for health care or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations; establishing mechanisms for the reimbursement and financing of health care services, including rate-setting, development of capitation reimbursement methodologies, and development of fee schedules; performing utilization review of requests for medical treatment including prior approval or authorization activities, adjudication of claims for payment and/or provider credentialing; AND/OR conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.
*Substitution: An associate degree can substitute for two years of specialized experience; a bachelor’s degree can substitute for four years of experience; a master’s degree in a related field can substitute for five years of experience; and a doctorate in a related field can substitute for six years of experience.
Preferred Qualifications: Experience with NYS Health Insurance Programs (Medicaid, CHP, EP, APTC) eligibility requirements. Experience using eMedNY, NYSOH, WMS, MECM systems.
Experience in user acceptance testing. Experience in project management. Good attention to detail, excellent verbal and written communication skills.
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.
We offer a work-life balance and a generous benefits package, worth 65% of salary, including:
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.
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.
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 Medical Assistance Specialist 1 will work within the Eligibility Systems Modernization Group (ESMG) as part of a team responsible for implementing the Medicaid policy/legislative changes to the Rest of State (ROS) Welfare Management System (WMS); assisting in the development and testing of the Medicaid Eligibility and Client Management (MECM) system; executing User Acceptance Testing(UAT) for policy/legislative changes to NYSOH; the transition of populations out of WMS into NYSOH and MECM; provide project support where changes to NYSOH, eMedNY, and the MECM impact WMS interfaces; Production support including file transfers, Help Desk, defect analysis and remediation for MECM and ROS WMS; and the support of continuous improvement activities required to reduce risk and minimize the negative consequences of implementing business systems change.
The incumbent will be primarily responsible for work efforts for the Bureau of Upstate Eligibility Systems (UES) as part of the Testing team related to the implementation of rule changes in compliance with the federal HR1 (Big Beautiful Bill) legislation including, but not limited to:
Participates in development activities with staff and contractors, including meeting with stakeholders, to track system behavior and documentation.
Reviews system change requests to ensure systems adhere to applicable Program policies.
Collaborate with other departments and stakeholders to review system change documentation.
Drafts, reviews, and updates training and guidance documents, manuals, and
job aids.
Writes procedure manuals and documents process.
Develop and implement test plans, test cases, and test scripts based on information shared in joint application design sessions, functional and interface documentation, and other sources.
Develops test data and scenarios, tests systems functions in UAT, and documents the results.
Current New York State Department of Health employee with permanent or contingent-permanent status as a Medical Assistance Specialist 1, G-18, OR; Current New York State employee with one year or more of permanent or contingent-permanent, competitive service in a title eligible to transfer under Section 52.6 or Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 1, G-18.
Non-Competitive Qualifications via NY HELPS:
Six years of experience* developing public or private health related policy; analyzing AND interpreting public or private health related policy to assist consumers; determining or reviewing financial eligibility for health care or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations; establishing mechanisms for the reimbursement and financing of health care services, including rate-setting, development of capitation reimbursement methodologies, and development of fee schedules; performing utilization review of requests for medical treatment including prior approval or authorization activities, adjudication of claims for payment and/or provider credentialing; AND/OR conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.
*Substitution: An associate degree can substitute for two years of specialized experience; a bachelor’s degree can substitute for four years of experience; a master’s degree in a related field can substitute for five years of experience; and a doctorate in a related field can substitute for six years of experience.
Preferred Qualifications: Experience with NYS Health Insurance Programs (Medicaid, CHP, EP, APTC) eligibility requirements. Experience using eMedNY, NYSOH, WMS, MECM systems.
Experience in user acceptance testing. Experience in project management. Good attention to detail, excellent verbal and written communication skills.
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.
We offer a work-life balance and a generous benefits package, worth 65% of salary, including:
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.
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.
New York State agencies, departments, and public authorities provide services across healthcare, engineering, administration, public safety, the trades, and other areas.