Senior Healthcare Program Specialist - Quality Assurance

Staffing Solutions Organization LLC (SSO) • Albany, NY

90d

About The Position

This person will work within the DEMI Bureau of System Quality Assurance and System Requirements. The Bureau conducts quality assurance of the NYSOH Marketplace performance relating to program eligibility determinations, enrollment functionality and notice generation. This person will be reviewing accounts to ensure that eligibility was determined correctly for Medicaid, Child Health Plus and Qualified Health Plans, including APTC, and if related enrollment functionality is correct; and ensuring systems are operated in a manner consistent with federal and state statute and regulations.

Requirements

• 8 years of professional experience.

Nice To Haves

• Professional experience in public health insurance programs, including Medicaid, Medicare, and/or Child Health Plus.
• Excellent verbal and written communication skills.
• Strong analytical skills and attention to detail.
• Strong organizational skills.
• Proficiency in Microsoft Office (Word, Excel, Access).
• Ability to work well independently and as part of a team.
• Ability to manage multiple priorities in order to meet deadlines.
• Experience using electronic data systems, such as Medicaid Management Information Systems and health insurance eligibility systems.

Responsibilities

• Conduct quality assurance of the NYSOH Marketplace performance relating to program eligibility determinations.
• Review accounts to ensure that eligibility was determined correctly for Medicaid, Child Health Plus, and Qualified Health Plans.
• Ensure related enrollment functionality is correct.
• Ensure systems are operated in a manner consistent with federal and state statute and regulations.

What This Job Offers

• Career Level: Mid Level
• Number of Employees: 11-50 employees