Senior Healthcare Program Specialist

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.

Senior Healthcare Program Specialist, Albany NY
DHPCO - 1070

Duties Description:

This individual will assist senior staff in the New York State Department of Health, Office of Health Insurance Programs (OHIP), Division of Health Plan Contracting and Oversight, Bureau of Consumer Services in implementing and evaluating health reform initiatives with a primary focus on research and analysis associated with the transition and monitoring of vulnerable populations into managed care. 

Additional duties include: provide data analysis for the development of information and insight to support the Bureau’s complaint investigations; research and analyze Managed Care Organization (MCO) business process data to prevent/ensure appropriate health care services and benefits are provided as defined under NYS regulations and contract requirements; provide assistance with the design, implementation and maintenance of application programs and databases to support program operations and decision making; provide research into MCO business processes to identify operational deficiencies or systemic problems associated with enrollee management and provider billing; assist with onsite or remote MCO business process reviews related to the identification and implementation of corrective actions for consumer service and benefit delivery problems and provider payment in-accuracies; draft a wide range of documents which may include status reports and guidance documents; other activities as may be deemed necessary in response to the changing needs of the Division  

Minimum Qualifications:

• Bachelor’s degree 
• Five (5) years’ experience

Preferred Qualifications:

• Experience in managed care, care coordination, Medicaid, compliance, and/or delivery of Strong analytical and communication (both written and oral) skills
• Experience in health research and business analytics
• Proficient in the use of standard office technology and Microsoft applications including Word, Excel, Access, and PowerPoint.
• The ability to work independently in conducting research to support DOH policy
• The ability to function in a team environment.