Health Care Surveyor 2 (Nursing)

Open to DOH and NYS employees only.

Agency New York State Department of Health
Title Health Care Surveyor 2 (Nursing)
Salary $54,045 - $68,637
Salary Grade Grade 19
Negotiating Unit 05/Professional Scientific and Technical
Location Office of Health Insurance Programs Division of OHIP Operations Bureau of Medicaid Prior Approval 150 Broadway, Suite 600, Riverview Center Menands, NY 12204
Minimum Qualifications Current Department of Health employee with permanent or contingent-permanent status as a Health Care Surveyor 2 (Nursing) OR other NYS employee with one year of permanent or contingent-permanent service as a Health Care Surveyor 2 (Nursing) or in a title at Grade 17 or above and eligible for 70.1 transfer OR eligible for transfer under Section 70.4 of the Civil Service Law with the following: You must be licensed and currently registered to practice nursing in New York State and have three years of post-licensure professional nursing experience, at least two of which must have been professional clinical nursing experience in a licensed health care facility. A bachelor's or master's degree in nursing can be substituted for one year of required general nursing experience.
Preferred Qualifications Experience in rehabilitation, home care, medical coding and automated healthcare systems; knowledge of laws, rules, and regulations and polices relating to the Medicaid program; excellent interpersonal, communication, writing, analytical and computer skills; ability to work independently as well as part of a team; and ability to organize and prioritize.
Responsibilities The incumbent will perform various pre-payment review functions in the Medicaid program through the electronic prior approval and reference file systems. These include reviewing prior approval requests for durable medical equipment, private duty nursing and physician services to determine if the service falls within the scope of coverage of the Medicaid program and if the service is appropriate for the particular individual's medical needs. This function requires the use of professional medical judgment in the examination of the proposed treatment plan or equipment purchase for the patient and written and telephone communication with outside stakeholders. The position involves utilizing national standards for procedure and diagnosis coding, reviewing appropriate combinations of medical services, and identifying methods to prevent fraud and abuse.
Conditions of Employment Permanent, full-time. Minimal, if any, travel required.
Application Procedure Submit resume to Human Resources Management Group, 89411/HCS2/CB, Room 2217, Corning Tower Building, Empire State Plaza, Albany, New York 12237-0012, or by e-mail to resume@health.state.ny.us or by fax to (518) 473-3395. Please use a subject line of 89411/HCS2/CB.
Submit resumes by Until position is filled.

An affirmative action/equal opportunity employer. Women, minorities and people with disabilities are encouraged to apply.

Item # 89411
Issued October 18, 2013