Social Workers

Mission statement of OHIP :

The overall mission of the Office of Health Insurance Programs is to optimize the health of Medicaid members by wisely using all available resources. OHIP is responsible for administering New York's Medicaid budget by collaborating with stakeholders across the health care industry including other state agencies, local and federal government agencies, providers, members, and community-based organizations. OHIP is also responsible for implementation of major initiatives including Medicaid Redesign, the Affordable Care Act, and State Administration of Medicaid.

Division functions :

DPDM is responsible for all policy and strategic planning including waiver and State Plan Amendments, and policy related to medical, dental, pharmacy (including EPIC), behavioral health and transportation management. This division serves as the liaison to the Governor's office, Centers for Medicare and Medicaid Services, and other state-agencies.

Position Description :

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 experience and knowledge to develop expertise in assigned policy areas and assist with Medicaid policy development, implementation and oversight; analyzing current and proposed processes and reports; conducting HCBS eligibility assessment determinations for Waiver applicants and enroll eligible participants; corresponding with providers, participants and other stakeholders; and reviewing, 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.

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.

• 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.
• 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.
• Conduct HCBS eligibility determination assessments for Waiver applicants and enroll eligible participants. This includes managing referrals, providing assistance and program education, conducting initial screenings, gathering assessment information from the applicant, and providers, determining eligibility, enrolling participants and transferring participants to their choice of Children's Health Home.
• Monitor and analyze reports and feedback to provide updates on HCBS eligibility and enrollment status to leadership
• 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.
• Provide input on policies, procedures and decisions related to HCBS eligibility and enrollment, and other program areas as assigned. Develop program education and guidance materials and assist in keeping the DOH website up to date.
• Become proficient with management information systems and provide input on enhancements focused on improving / streamlining processes.
• Evaluate program implementation strategies. Synthesize information to determine the need for changes to current services / procedures and present solutions for improvements.
• 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.
• Other activities as may be deemed necessary in response to the changing needs of OHIP.

Additional Skill Level, Experience or Other Requirements :

Preferred years of experience : 6-8 years

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.