APPLICANTS MUST BE PERMANENT IN THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE The Medical Assistance Program (MAP) administers public health insurance programs, including Medicaid, for the City of New York. Applying individuals and families are approved for eligibility against applicable Federal and State guidelines. Those found to be eligible can use coverage provided to access doctors, medication and other health care services at little or no cost.
The Excess Income/ Surplus Program is responsible for evaluations of Public Health Insurance Renewals and Medicare Saving Program (MSP) Applications. The unit determines eligibility by evaluating financial and legal documentation to ensure accurate income and resources are applied when budgeting Medicaid cases for retroactive and prospective coverage. Review and verify Medical Bills in the program assessment process, when paid and unpaid medical bills are submitted by applicants/recipients and authorized representatives to determine coverage for clients over the Medicaid level (allowing coverage; either monthly or up to six-months at a time).
The Medical Assistance Program (MAP) is recruiting for one (1) Principal Administrative Associate, Level III to function as a Section Manager who will:
- Oversee and manage activities of Excess Income’s Undercare renewals, Pay-In, e-Fax, Provider Bills, Constituent inquiries, Medicare Saving Program (MSP) and Pooled Trust units. Receive cases from all agency sites through the EDITS Plus system for review and distribution to the PAA II/Section Supervisor.
- Assess difficult, high-profile cases concerning Hospital Eligibility, Home Care, Nursing Home Eligibility and Out-Stationed Eligibility by researching and interpreting applicable Federal/State laws and regulations and providing updates and analysis of each case.
- Consult with the Director on program challenges and provide guidance to management on complex issues and administrative personnel matters.
- Analyze and monitor completion of trust cases submitted to the Community and Homecare program, including Pooled, Revocable/Irrevocable and Supplemental Needs.
Establish monthly reports on State Disability Review submissions. Consult with Office of Legal Affairs (OLA) and other legal entities on Pooled Trust cases.
- Interact with other Medical Assistance Program (MAP) area divisions, external agencies including SDRT (State Disability Review Team) CAS (Customized Assistance Service) and an excess of over 100 community-based organizations, to meet program objectives.
- Interpret State/Federal policies to ensure Surplus/Homecare/Nursing Home/Out Station Eligibility and Community Eligibility Division programs are in compliance with Medicaid Laws.
- Oversee the Welfare Management System (WMS) error correction process, identify problem areas associated with the errors in each unit. Institute corrective action plans based on data collected from Case Circle Review state audits for the Divisional Director. Evaluate program workflow and processes, identifying operational inefficiencies.
- Conduct weekly “White Board” collaborative meetings with three divisions to isolate and address specific errors. Propose remedial measures to streamline and improve operations ensuring deficiencies are addressed. Ensure case actions are accurate, and information properly documented in the event of an audit or administrative review.
- Prepare weekly statistical reports on the manual/electronic section’s activities.
- Conduct and participate in unit staff meetings to ensure all relevant information is shared with staff, and new policy directives are implemented. Participate in conferences with the Director and Divisional Director regarding the functioning of the units and formulate recommendations for improvement.
- Perform confidential HR functions. Monitor and maintain control of subordinate's job performance and activities. Ensure adherence to HRA’s Code of Conduct and Time and Leave policies, initiate disciplinary actions as needed.
- Train staff to ensure eligibility determinations are accurate and consistent with applicable laws and regulations. Evaluate staff performance on an on-going basis.
- In the absence of the Director, the Section Manager may be called upon to assume the responsibilities of that position.
Hours/Shift: 9AM – 5PM (1 Hour Flex)
Minimum Qualifications
- A baccalaureate degree from an accredited college and three years of satisfactory full-time progressively responsible clerical/administrative experience, one year of which must have been in an administrative capacity or supervising staff performing clerical/administrative work of more than moderate difficulty; or
- An associate degree or 60 semester credits from an accredited college and four years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience described in "1" above; or
- A four-year high school diploma or its educational equivalent approved by a State's department of education or a recognized accrediting organization and five years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience as described in "1" above;
- Education and/or experience equivalent to "1", "2", or "3" above.
However, all candidates must possess the one year of administrative or supervisory experience as described in "1" above.
Education above the high school level may be substituted for the general clerical/administrative experience (but not for the one year of administrative or supervisory experience described in "1" above) at a rate of 30 semester credits from an accredited college for 6 months of experience up to a maximum of 3½ years.
Preferred Skills
- Medicaid Knowledge
- Strong Supervisory and Communication skills
- Proficient in Word & Excel
Residency Requirement
New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.
Additional Information
The Human Resources Administration/Department of Social Services/ Department of Homeless Services offers competitive salaries and the following benefits: Generous Pension Plans (The New York Employees' Retirement System); 401(k) and Roth 457 Retirement Savings Programs; U.S. Savings Bonds Flexible Spending Program; Health Benefits, Dental, Vision Coverage, Prescription Drug Program; Training and Professional Development; Opportunity for Scholarship; College Savings Program; Paid Holidays and Generous Annual Leave.