Medicaid Eligibility Examiner 1/Trainee (NY HELPS) - 79051, 13559, 79059, 79060

NY HELPS Yes

55-b/c Eligible Yes

Agency Health, Department of

Title Medicaid Eligibility Examiner 1/Trainee (NY HELPS) - 79051, 13559, 79059, 79060

Occupational Category Other Professional Careers

Salary Grade 09

Bargaining Unit ASU - Administrative Services Unit (CSEA)

Salary Range From $37862 to $54773 Annually

Employment Type Full-Time

Appointment Type Contingent Permanent

Internship No

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 Eligibility and Marketplace Integration/Bureau of Consumer Relations and Local District Support

99 Washington Avenue

City Albany

State NY

Zip Code 12210

Duties Description The Medicaid Eligibility Examiner 1 (MEE 1) within the State Disability Review Unit’s Medical Evidence Gathering Group is responsible for the comprehensive collection and coordination of medical documentation required for Medicaid disability determinations. The incumbent manages a high-volume caseload, acting as a professional liaison between the Department and external stakeholders, including applicants, physicians' offices, and hospital systems-to procure essential clinical records and diagnostic reports. Key duties include utilizing the Medicaid Disability Determinations System (MDDS) to track evidence-gathering progress, auditing incoming documentation for completeness and legibility, and ensuring all activities remain in strict compliance with state deadlines and HIPAA privacy standards. By efficiently bridging the gap between healthcare providers and the unit’s clinical staff, the MEE 1 ensures that the necessary evidence is available for nurses and medical consultants to conduct timely and accurate eligibility reviews.

Minimum Qualifications Permanent Transfer:Current NYS Department of Health employee with permanent or contingent-permanent, competitive status as a Medicaid Eligibility Examiner (G9) OR a NYS employee with one year or more of permanent or contingent-permanent, competitive service in a position at or above a grade 6 and eligible for transfer under Section 70.1 of the Civil Service Law. Non-Competitive via HELPS:Medicaid Eligibility Examiner 1: Two years of experience determining or reviewing financial eligibility for healthcare or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations or performing quality assurance activities to ensure compliance with laws, rules, regulations, and policies in a health care delivery system including health care facilities; federal, State, or local health care agencies; hospitals; Medicaid programs; and/or other public or private health insurance programs.30 semester credit hours can substitute for one year of experience.Medicaid Eligibility Examiner Trainee 1: There are no minimum education or experience requirements. If you are appointed to a Trainee title, upon successful completion of a 12-monthtraineeship, you will automatically advance to the full journey level of the title, Grade 9.Preferred Qualifications: Preferred candidates will have professional experience in public health insurance programs, including New York’s Medicaid, Medicare and/or Child Health Plus. Preferred candidates will also have excellent verbal and written communication skills; strong analytical skills and attention to detail; strong organizational skills; proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team, and to manage multiple priorities in order to meet deadlines; and experience using electronic data systems, such as eMedNY and NYSOH Back Office. Supervisory experience is a plus.

Additional Comments 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:• 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.htmIf 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 [email protected] 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.

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

Name Human Resources Management Group, SPD/MEE1/BCRCDS

Telephone 518-486-1812

Fax 518-473-3395

Email Address [email protected]

Address

Street Corning Tower, Empire State Plaza. Room 2217

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 [email protected], with Reference SPD/MEE1/BCRCDS included in the subject line or by mail to Human Resources Management Group, SPD/MEE1/BCRCDS, 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.