Duties Description The Office of Health Insurance Programs, within the Division of Medical & Dental Directors, in the Bureau for Children with Medical Complexity is seeking a The Health Care Surveyor 4 (Nursing) position. The Bureau for Children with Medical Complexity (BCMC) is responsible for addressing the needs of children with medical complexity and overseeing Medicaid services that support this population. The Health Care Surveyor 4 (Nursing) will serve as a unit manager within BCMC and will oversee the Medically Fragile Waiver Enrollment Unit and the Environmental Modification, Vehicle Modification, Assistive Technology, and Financial Management Services (EMOD/VMOD/AT/FMS) Unit. Duties include: Oversee day-to-day operations of the assigned units, including staff, workloads, and program activities; Supervise nursing and clinical review staff responsible for waiver enrollment, service reviews, and regulatory and quality assurance activities; Oversee clinical reviews, complaints, incidents, prior approvals, and claims review activities; Ensure compliance with applicable federal and state requirements, Medicaid policies, and standards of clinical practice; Use program data and feedback from children and families, healthcare providers, and other stakeholders to identify needs and opportunities for program development and quality improvement; Lead or support innovative approaches to improve access, service delivery, consistency, and outcomes for medically fragile children; Interpret and provide guidance on program policies, procedures, and requirements; Coordinate with healthcare providers, vendors, contractors, case management entities, OHIP divisions, and other department offices to support program operations and resolve issues; Monitor provider and vendor performance; and assist with the development and implementation of policies and procedures related to the assigned programs.
Minimum Qualifications Permanent Transfer Candidates: Current NYS Department of Health employee with one year of permanent or contingent-permanent, competitive, service as a Health Care Surveyor 4 (Nursing) G25 and eligible to transfer under Section 70.1 of the NYS Civil Service Law.
Non-competitive via HELPS: Possession of a license and current registration as a registered professional nurse in New York State and three years of post-licensure, specialized professional administrative or professional clinical experience. One year of the experience must have been at a supervisory level.
Substitution: A master's degree in nursing may substitute for one year of post-licensure clinical nursing experience; and a doctorate in nursing may substitute for two years of post-licensure clinical nursing experience.
Preferred Qualifications: Experience and knowledge in the following areas will be beneficial: supervision of nursing and/or clinical staff; Medicaid programs and services for children with medical complexity; Children's Waiver and home and community-based services; clinical review and quality assurance; State and federal health care requirements; provider and vendor oversight; and coordination with healthcare providers, contractors, and other stakeholders.
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.
Posted salary range includes the statutory hiring rate at Step 4 and job rate for PS&T Grade 25 ($113,459 to $126,875) and an additional Geographic Pay Differential of $20,000.
Name Human Resources Management Group, EW/HCS4N/80146
Fax 518-473-3395
Email Address resume@health.ny.gov
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 resume@health.ny.gov, with Reference EW/HCS4N/80146 included in the subject line or by mail to Human Resources Management Group, EW/HCS4N/80146, 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.
