Eligibility Program Manager

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.

Eligibility Program Manager - Albany NY

DEMI - 1027

Summary

Within the Division of Eligibility and Marketplace Integration (DEMI), Eligibility Systems Modernization Group, the incumbent will manage multiple staff who provide support for activities related to the implementation of the new eligibility system, and the implementation of the new appeals management system for New York’s Complex Medicaid population. 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. The incumbent will be responsible for assigning tasks in the unit, identifying planning and policy needs, and drafting proposals to help address those needs, creating test plans, and performing end user testing activities.

Basic 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, business requirements and operational requirements.
• Interpret guidance and instructions related to Medicaid eligibility, health insurance appeals, enrollment, 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.
• Provide supervision and ensure implementation is on schedule or address delays in schedule.
• Assist in the development of policies; recommend modifications as needed to procedures, operational workflows, and reporting systems for implementing programs and programmatic changes.
• Attend and participate in the Critical Thinking Meetings and Joint Application Development sessions.
• Provide supervision, guidance, and oversight to subordinate staff. Determine and oversee staff assignments and reassignments, monitors time and attendance.
• Perform end user testing activities for the new eligibility system for New York’s Complex Medicaid population, and the new appeals management system.
• Assist in the supervision and planning of tasks related to training, communications, and operational readiness for the new eligibility system and the new appeals system.

Basic Qualifications:

Bachelor's Degree in related field,

10 years experience, 5 years subject matter experience

Supervisory experience