Healthcare Program Specialist - Bureau of Consumer Services Investigations Unit in Albany, NY at Public Consulting Group

Date Posted: 3/27/2021

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Albany
    Albany, NY
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    3/27/2021

Job Description

Staffing Solutions Organization LLC (SSO), a wholly owned subsidiary of Public Consulting Group, is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.
Healthcare Program Specialist - Division of Health Plan Contracting & Oversight
Item 1059

Position Summary:

This position is located within the Office of Health Insurance Program’s Division of Health Plan Contracting and Oversight - Bureau of Consumer Services Investigations Unit. The incumbent acts as a liaison between State agencies, health care providers, enrollees and managed care plans to assure appropriate access and delivery of health services and benefits in the Medicaid managed care program.  


Additional duties include: Assist in planning and coordination on development of appropriate healthcare complaint resolution processes and a broad range of planning, implementation, and oversight activities related to Medicaid managed care program; conduct investigations to resolve enrollee or provider complaints and/or respond to inquiries and requests for information; manage and organize complaint case files including maintaining accurate and current case information in the complaint database; and other activities as may be deemed necessary in response to the changing needs of the Division.

Requirements:

-        -Bachelor’s Degree

-        -A minimum of two (2) years of professional experience in a health care program that: reimburses for health care services; provides health care services directly; provides health care regulatory oversight: performs quality assurance and interpretation/application of standards of health care; manages health care utilization, or conducts health care coordination activities.

-        -Experience or knowledge of NYS public health insurance programs (e.g., Medicaid, Managed Care, -CHPlus or Health Benefit Exchange.)

-        -Strong analytical, research and communication (both written and verbal) skills.

-        -The ability to work independently in conducting research to support DOH policy

-        -The ability to function in a team environment.
- Must be a U.S Citizen or a Permanent Resident of the U.S. in order to be considered.


All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability.  Staffing Solutions Organization LLC is an e-Verify participant.


Other details

  • Pay Type Hourly
  • Required Education Bachelor’s Degree
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  • Albany, NY, USA