The Medical Assistance Program (MAP) administers Medicaid and related public health insurance programs, for the City of New York. Applying individuals and families are approved for eligibility against applicable Federal and State guidelines. Those found to be eligible can use coverage provided to access doctors, medication, and other health care services at little or no cost.

The Medical Assistance Program (MAP), is recruiting for one (1) Deputy Director of Administration (MA) M-II, to function as the Director of Research and Program Monitoring.

Under the direction of the Assistant Deputy Commissioner (ADC) for Medicaid Program Strategy and Support, with wide latitude for the exercise of independent judgment, initiative and action, the MAP Director of Research and Program Monitoring is responsible for promoting efficiency and uniformity in MAP processes, in keeping with applicable laws and regulations, in the process of providing consumers those benefits to which they are entitled.

The Director is accountable for the interpretation of Federal/State/City procedural protocols and legal mandates impacting MAP operations. The Director is also responsible for covering the ADC responsibilities when the ADC is out of the office including but not limited to supervising the areas reporting to the ADC – Business, Solutions and Support; Staffing and Resources; and Administrative Services and Facilities Management, making decisions on implementing program changes and working closely with the Executive Deputy Commissioner in place of the ADC.

The Director of Research and Program Monitoring will:

- Direct special projects and initiatives as designated by the Assistant Deputy Commissioner,
stemming from regulatory changes and/or Commissioner initiatives that require operational research,
document findings and synthesizes the Medicaid eligibility issues for use by the Office of Legal Affairs
and in-house senior management. Research and design work plans for implementing regulatory
changes and Commissioner initiatives, manage research projects requiring evaluative and applied
research of the highest level of difficulty.

- Manage MAP responses to Federal, State and internal audits of Medicaid eligibility cases by
reviewing relevant State guidance and MAP procedures. Guide operational staff on the outcome of
responses to Medicaid cases identified by auditors. Develop corrective actions in response to audit
findings by coordinating with the Office of Policy, Procedures, and Training (OPPT), the Medical
Assistance Quality Control Unit (MAQC), and the Bureau of Audit Control.

- Serve as a principal advisor to the Assistant Deputy Commissioner on program issues relevant to
policy and procedural interpretation, including risks identified at operational meetings, research
findings and implications.

- Represent the ADC in a leadership capacity at executive/administrative level meetings and
conferences within the Agency and with government officials. Maintain contact with governmental
agencies regarding MAP implementation/compliance with Federal, State, and local laws, policy,
procedure, rules, and regulations as it pertains to Medicaid insurance.

- Conduct complex analyses and evaluations of programmatic operations to identify deficiencies in
adhering to Federal and State Medicaid rules, agency policies, procedures, and regulations.
Correlate complex analyses of Medicaid eligibility processes related to error rates, consumer
complaints, and compliance activities, identifying performance trends and tracking processes for
uniformity and efficiency. Provide guidance to the program areas on regulatory compliance issues.

- Ensure that Medicaid records are maintained in accordance with Federal and State regulations by
observing and reporting protocols that have been fully vetted and implemented by MAP for use by staff
and Office of Legal Affairs (OLA)/ Health Insurance Portability and Accountability Act (HIPAA) Officer.
Coordinate with OLA to ensure systemic compliance with HIPAA requirements. Ensure MAP compliance
with Department of Records and Information Services Regulations with regards to document retention
and destruction.

- Serve as liaison to the Office of Investigation, Revenue, and Enforcement Administration (IREA),
Constituent Services, Office of Legal Affairs (OLA), Administration for Children’s Services (ACS), New
York State Department of Health (SDOH), State Disability Review Team, Office of the Medicaid
Inspector General (OMIG), advocacy groups and vendors concerning Medicaid eligibility, Federal, State
and local policy, procedures, rules, and regulations.

- Manage and maintain the MAP Virtual File Cabinet, a comprehensive virtual database containing a
repository of searchable management documents including audits, litigation, executive decisions, and
Medicaid program compliance legislative enactments. This database provides a historical basis for
Agency actions for potential litigation and audits.

- Provide guidance to directors and executive management in the facilitation of cooperation and
coordination on problematic cases to develop effective solutions to problem cases.

1. A baccalaureate degree and four (4) years of full-time executive experience, involving the direction of large numbers of employees, and having responsibility for the formulation and execution of programs and policy in a public or major social welfare agency or in a large hospital or a hospital system or a large public health program; or
2. Education and/or experience equivalent to "1" above. However, all candidates must have at least one (1) year of the specialized experience described in "1" above. A master's degree in a social work, public health, hospital administration or other appropriate field will be accepted as equivalent to two (2) years of experience.

- Strong management and communication skills with internal and external stakeholders. - Experience leading teams/areas with several layers of staff. - Understanding and knowledge of Medicaid and Medical insurance.

New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.

The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.