Medicaid Program Advisor - Eligibility Systems

Staffing Solutions Organization LLC (SSO)•Albany, NY

About The Position

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), 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. Medicaid Program Advisor 1 in Albany, NY Division of Eligibility and Marketplace Integration (DEMI) Eligibility Systems Modernization Group Item 1023 Duties: Within the Division of Eligibility and Marketplace Integration (DEMI), Eligibility Systems Modernization Group, this person will provide support for activities related to the implementation of the new eligibility system for New York’s Complex Medicaid population, and the new appeals management system. The individual will act as a liaison between the DEMI policy team, and other stakeholders and vendors, to provide system requirements related to eligibility and enrollment in New York’s Medicaid program. Specific duties and responsibilities may include but are not limited to:

Requirements

8 years of professional experience

Nice To Haves

The preferred candidate would have knowledge of New York public health insurance program eligibility and enrollment policies; demonstrated ability to manage multiple priorities and meet deadlines; experience with the development of websites, program applications, databases, other program tools, and requirements documentation and elicitation.

Responsibilities

Act as a liaison with the policy and legal departments to coordinate the implementation of State and Federal initiatives
Work with teams of vendors, DOH staff and other stakeholders as needed (e.g. issuers, application assistors) to elicit, document, analyze policy, and develop business needs and requirements.
Interpret guidance and instructions related to Medicaid eligibility, enrollment, appeals processes, and notices from a requirements perspective; perform analysis for bureau and division-level staff; and make recommendations for improvement.
Follow up with DOH subject matter experts (SMEs), system vendors and other stakeholders as needed to resolve requirement questions and identify where gaps may occur.
Review requirements documentation and validate requirements with policy, systems and/or vendor staff as needed.
Assist in the development of policies; recommend modifications as needed to procedures and reporting systems for implementing programs and programmatic changes.
Attend and participate in the Critical Thinking Meetings and Joint Application Development sessions.
Perform end user testing activities for the new eligibility system for New York’s Complex Medicaid population, and the new appeals management system.
Assist with the coordination of tasks related to training, communications, and operational readiness for the new eligibility system and the new appeals system.
Creating test plans and performing end user testing activities.