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SENIOR SYSTEMS MEDICAID ANALYST

  1. HRA/DEPT OF SOCIAL SERVICES
Posted on: 08/21/2023
  1. Full-time

Location

MANHATTAN

  1. Exam may be required

Department

Revenue Mgmt/Development-NM

$70,611.00 – $81,203.00

Job Description

This vacancy has now expired.

The Office of Revenue Management & Development (ORMD) maximizes federal and state funding of HRA costs through the activities of developing revenue-enhancing initiatives and carrying out revenue-generating projects, savings millions of City tax levy dollars.

ORMD is recruiting for one (1) Associate Staff Analyst to function as the Senior Systems Medicaid Analyst within the Revenue Enhancement and Analysis unit, who will:

- Ensure that correct policies and procedures have been followed by reviewing documents and procedures that may have been supplied by other HRA programs. Review State or Federal legislation/regulations or data extracted by querying the Enterprise Data Warehouse (EDW) to identify expected impact of policy or legislative change, on Agency claiming projects.

- Execute SQL scripts for a variety of MA claiming projects including Customized Assistance Services (CAS) Case Management Services. Matche the CAS client population to identify MA eligible clients using the EDW. Submit quarterly adjustment claims for each vendor to Bureau of Claims and Reimbursement (BCR).

- Generate a quarterly claim for Skilled Professional Medical Personnel (SPMP) Placement Assessment and Client Tracking Unit (PACT) and Visiting Psychiatric Services (VPS). SPMP/PACT and VPS professional staff who provide services to Medicaid eligible clients are claimed for enhanced SPMP Medicaid reimbursement. Using SQL and Enterprise Data Warehouse, matches the CAS client population to identify MA eligible clients. Submit quarterly adjustment claims for each vendor to BCR.

- Run a series of complex SQL algorithm using the Enterprise Data Warehouse to captured clients with duplicate Client Identification Numbers (CINs), resulting in duplicate capitation payments to the Managed Care Providers. Generate a final bill for recoupment and sent to the Agency Medical Insurance and Community Services Administration for recovery. -20%

- Utilize Excel, Access, SQL, Oracle OBIEE, WMS, CPR, or other database programs to perform qualitative analysis for revenue claims and projects, as needed. Senior Systems Analysts will supplement training provided by the Agency with efforts to improve technical skills and business knowledge.


Minimum Qualifications

1. A master’s degree from an accredited college or university, accredited by regional, national, professional or specialized agencies recognized as accrediting bodies by the U.S. Secretary of Education and the Council for Higher Education Accreditation (CHEA) in economics, finance, accounting, business or public administration, human resources management, management science, operations research, organizational behavior, industrial psychology, statistics, personnel administration, labor relations, psychology, sociology, human resources development, political science, urban studies or a closely related field, and one year of satisfactory full-time professional experience in one or a combination of the following: working with the budget of a large public or private concern in budget administration, accounting, economic or financial administration, or fiscal or economic research; or in management or methods analysis, operations research, organizational research or program evaluation; or in personnel or public administration, recruitment, position classification, personnel relations, labor relations, employee
benefits, staff development, employment program planning/administration, labor market research, economic planning, social services program planning/evaluation, or fiscal management; or in a related area; or
2. A baccalaureate degree from an accredited college or university, accredited by regional, national, professional or specialized agencies recognized as accrediting bodies by the U.S. Secretary of Education and the Council for Higher Education Accreditation (CHEA) and three years of satisfactory full-time professional experience in the areas described in “1" above.


Preferred Skills

- Excellent experience in quantitative and statistical analysis of financial reports. - Strong verbal, written communication and analytical skills. - Extensive experience in the financial area within Government Agencies and knowledge of Federal, State, and local/city policies and mandates.
55a Program

This position is also open to qualified persons with a disability who are eligible for the 55-a Program. Please indicate at the top of your resume and cover letter that you would like to be considered for the position through the 55-a Program.
Residency Requirement

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.
Additional Information

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.

Job ID

571362

Title code

12627

Civil service title

ASSOCIATE STAFF ANALYST

Title classification

Competitive-1

Business title

SENIOR SYSTEMS MEDICAID ANALYST

  1. Experienced (non-manager)

Job level

00

Number of positions

1

Work location

4 World Trade Center

  1. Constituent Services & Community Programs

SENIOR SYSTEMS MEDICAID ANALYST

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