Medicaid Registered Nurse

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 Registered Nurse – Albany, NY

(Position 100% remote)

Summary:

The Bureau of Specialized Services for Children (BSSC) in the Division of Program Development and Management (DPDM) has overall responsibility for program policy governing a wide range of services and programs for children provided under the Medicaid program including the Children’s Health Home program, the voluntary foster care agencies (VFCA) 29-I Health facilities, Home and Community Based Services (HCBS) Children’s Waiver for children/youth with behavioral health, medically complex, and developmental disabilities need. The incumbent will use their clinical knowledge to develop expertise in assigned policy areas and assist with Medicaid policy development, implementation and oversight; analyzing current and proposed service provision; authorizing services for participants; corresponding with providers, participants and other stakeholders; and reviewing and updating provider guidance materials.   

The candidate must have strong interpersonal, problem solving, decision-making and time management skills and the preferred candidate possesses knowledge of pediatric diagnoses and diseases that impact children's development and activities of daily living and has experience with pediatric home health care and related medical supports/supplies and has knowledge of Medicaid and Medicaid services. In addition, the ideal candidate understands Children Services including medical and behavioral health conditions regarding the various children’s populations of Serious Emotional Disturbance, Foster Care, Medically Fragile, Developmental Disabilities, and Substance Use and other chronic conditions.

1. Become knowledgeable and develop an understanding of the Children’s Health Home program, Home and Community Based Services (HCBS) Children’s Waiver, Children and Family Treatment and Support Services, and Foster Care/29-I services to determine changes and or enhancements to the services and programs.

2. Assist the supervisor and staff in the Office of Health Insurance Programs (OHIP), Division of Program Development and Management (DPDM) in a broad range of planning, implementation, evaluation, and reporting activities.

3. Research regulations and develop policies, procedures and guidance documents related to a wide range of subjects relevant to the development, implementation, and management of the children services, inclusive of developing power points, presenting training webinars, drafting announcements.

3. Provide clinical expertise and input on policies, procedures and decisions related to service authorizations for participants.

5. Lead program projects and initiatives addressing needs within the Children’s Services design.

6. Synthesize information and feedback to determine the need for new services or changes to current services. Evaluate and research implementation strategies for the services.  Present solution focus information regarding program services to the team and supervisor.

4. Collaborate and work with staff, contractors, and state partners regarding various project and program aspects of Children Services of the Health Homes and HCBS program as well as State Plan Services.

5. Assist with oversight and management of team assignments, and provide technical assistance and direction to staff, as needed.

6. Other activities as may be deemed necessary in response to the changing needs of OHIP.      

Basic Qualifications:

• Bachelor’s Degree
• Must have an active NYS RN license
• 4 years clinical healthcare experience, 2 years acute care experience