Estimated Length: 24 months Monday-Friday 8:30am - 5:00 pm

Requirements

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 (approximately $65B for 2018) 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:

Division of Eligibility and Marketplace Integration (DEMI)

DEMI is responsible for the establishment and implementation of eligibility and enrollment policies for Medicaid (MA), Child Health Plus (CHPlus) and Essential Plan (EP).  It is also responsible for eligibility and enrollment operations for NY State of Health, the online health insurance application for MA, CHPlus, EP as well as tax credits to purchase Qualified Health Plans.  The Division oversees a robust Customer Service Center that assists consumers in obtaining coverage, as well as thousands of community based assistors who provide in-person assistance.  The Division has also been charged with assuming the functions of the Local Departments of Social Services (LDSS) with respect to eligibility determination.  The third major role of DEMI is providing the eligibility business requirements for NY State of Health.  The Division also performs quality assurance to ensure the eligibility results are policy correct and conducts program integrity reviews.

Position Description:

Answers simple phone inquiries; redirects to professional staff/MAP/HBE etc. as appropriate;
Deals with difficult callers;
Uses the Welfare management system (WMS) and Emedny to find basic eligibility and coverage information;
Provides administrative support;
Directs faxes, incoming mail, incoming phone calls, schedule and coordinate meetings, files, basic copying, faxes using e-fax and multifunction printer;
Cooperates with fellow workers to achieve organizational goals.

Attitude:

• Responsible, efficient, detail-oriented and flexible.

Additional Skill Level, Experience or Other Requirements:

Has basic knowledge of MAGI and Non-MAGI eligibility criteria;
Maintains privacy and security of client data in accordance with HIPPA and Client guidelines;
Types accurately, creates, modifies and maintains word documents and excel spreadsheets;
Responsible, efficient, detail-oriented and flexible;
Language skills; Speaks Spanish

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