New York State Department of Civil Service Announces Open-­

Competitive Examination Open to the Public

Medicaid Eligibility Examiner 2

Evaluation of Training and Experience To Be Held DuringApril 2015

Applications Must Be Submitted or Postmarked ByMarch 04, 2015

Minimum QualificationsDutiesSubject of ExaminationHow to Apply

Exams Included on This Announcement

EXAM

NUMBEREXAM TITLE SALARY

SALARY

GRADE

NON

−REFUNDABLE

PROCESSING FEE

80-­194 Medicaid Eligibility Examiner 2 $45,018 G-­14 $0

Appointees who work in the five boroughs of New York City or in Nassau, Suffolk, Rockland, or Westchester Countieswill receive an additional $3,026 annual downstate adjustment. Appointees who work in Dutchess, Orange, or PutnamCounties will receive an additional $1,513 annual mid-­Hudson adjustment.

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Minimum Qualifications

On or before April 30, 2015, you must have four years of full time experience performing at least one of the sixactivities listed below in any of the following programs that: provides reimbursements for health care services;; workswith social services program areas;; determines eligibility for a consumer assisted program in a hospital or other healthcare facility;; provides health care regulatory oversight;; or performs quality assurance and interpretation/application ofstandards of health care.

Activities:

Either 1. determining eligibility for a health care or consumer assisted program in which financial eligibility criteriamust be met;;

Or 2. performing utilization review, including pre-­payment or post-­payment review of requested health care services,prior approval or authorization activities, adjudication or pricing of claims for payment;; or analysis of patterns of healthcare;;

Or 3. determining reimbursement and financing of health care services, including rate-­setting or approval, establishingcapitation reimbursement methodologies, assessing fee schedules, coding constructs for medical goods and services,

or applying/processing of reimbursement methodologies;;

Or 4. performing quality assurance activities such as ensuring compliance with laws, rules, regulations, and policies;;

Or 5. inspecting, assessing, or monitoring health care programs or facilities for certification, licensure or adherence tolaws, rules, regulations, and policies;;

Or 6. planning, designing, developing, researching, or evaluating proposals to establish or refine programs, withongoing responsibility for interpreting legislation or regulations, defining/describing target populations and localdemographics, grant/proposal writing, or developing, reviewing, and evaluating contracts.

Substitution: College credit may be substituted for up to two years of the general experience at the rate of 30 collegecredit hours equaling one year of experience. You must clearly demonstrate how you meet the remaining years ofexperience.

For the purposes of this exam, qualifying experience settings may include, but are not limited to: local district socialservices, hospitals or other healthcare facilities, health insurance companies, and health insurance call centers.

Non-­qualifying experience includes patient advocates, case managers, direct care experience, clerical and data entryduties, billing clerk, receptionist or scheduler in a physician’s office or hospital.

NOTES:

1. There is no processing fee for this exam.2. Applications must be mailed directly to the NYS Department of Health;; see “Where To Apply.”3. Your degree or college credit must have been awarded by a regionally accredited college or university or one

recognized by the NYS Education Department as following acceptable educational practices. If your degree orcollege credit was awarded by an educational institution outside the United States and its territories, you mustprovide independent verification of equivalency. You can write to the Examination Information Desk of the NYSDepartment of Civil Service for a list of acceptable companies who provide this service. You must pay therequired evaluation fee

4. If you meet the Minimum Qualifications you may also be interested in competing in Examination No. 80-­195,Medicaid Eligibility Examiner 3 and Examination No. 80-­196 Medicaid Eligibility Examiner 4.

5. Appropriate part-­time and volunteer experience, which can be verified, will be accepted on a prorated basis.6. New York State residence is not required.

THE POSITIONS

These positions exist in the New York State Department of Health.

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Duties

As a Medicaid Eligibility Examiner 2, you would supervise subordinate staff and perform duties related to the NewYork State Medicaid Program and other public health insurance programs within the Department of Health. You wouldplan and conduct staff training in response to revised regulations or procedures, schedule work and monitor workloadas well as quality assurance of work completed by staff. You would develop and review eligibility scenarios to test newcomputer applications and systems. You would process basic and more complex eligibility applications and addressspecific concerns for resolution of more complex applications that require interpretation of policies and procedures oradditional investigation.

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Subject of Examination

There will be no written test. The test will consist of an evaluation of your education and experience. When youapply, you must provide complete information to show that you meet the minimum qualifications. Do NOT sendresumes. If you apply using the NYS-­APP form and you need more space, attach additional 8½" x 11" sheetsfollowing the same format used on the application form. Additional unsolicited information will not be accepted afterthe last date for filing.

If you meet the Minimum Qualifications you will be sent a supplemental questionnaire to complete and return to theNYS Department of Health. The questionnaire will be used to evaluate the level, length, and relevance of youreducation and experience against the general background/critical activities of the position. This questionnaire will bethe only basis for rating your education and experience.

Your final score must be 70 or higher in order to pass. Rank on the eligible list will be determined after adding anywartime veterans' and Civil Service Law Section 85-­a credits to your final passing score.

How to Apply

Download examination application NYS-­APP form;; orEmail cs.sm.examinfo@cs.ny.gov to request NYS-­APP forms;; orObtain an NYS-­APP form from a State agency or facility personnel/business office;; orRequest NYS-­APP form by calling the Department of Civil Service in Albany at 518-­457-­2487 [press 2, thenpress 3] or toll free at 1-­877-­697-­5627 [press 2, then press 3].

Where to Apply

Mail your completed application to:

New York State Department of Health, Bureau of Personnel Management, Corning Tower, Room 2217,Albany, New York 12237.

Additional Information

New York State is an Equal Opportunity Employer

It is the policy of the State of New York to provide for and promote equal opportunity employment, compensation, andother terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability,national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violencevictim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon abona fide occupational qualification or other exception.

Appointment to many positions in State government require candidates to undergo an investigative screening. Thismay include a thorough character investigation, a Federal Bureau of Investigation Criminal Record History Check, aChild Abuse Registry clearance, or other similar procedures. Candidates may be fingerprinted and may be required topay any necessary fees for that procedure. Depending on the nature of the job, the criminal convictions discovered, orany falsified or omitted information revealed, the investigative findings may bar appointment or result in removal afterappointment.

Eligibility for Employment

You must be legally eligible to work in the United States at the time of appointment and throughout your employmentwith New York State. If appointed, you must produce documents that establish your identity and eligibility to work inthe United States, as required by the federal Immigration Reform and Control Act of 1986, and the Immigration andNationality Act.

S1/HXC-­dahIssued: 1/30/2015

This announcement is subject to amendment or cancellation without notice. Do not copy it, or post it to any other site,but link to it instead.

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