Executive Director, Office of Mail Renewal (OMR), Managed Care Program (MCP), and Third-Party H[...]

The Medical Assistance Program (MAP) administers Medicaid and related public health insurance programs for the City of New York. Applying individuals and families are approved for eligibility against applicable Federal and State guidelines. Those found to be eligible can use coverage provided to access doctors, medication, and other health care services at little or no cost.

The Medical Assistance Program (MAP) is recruiting for one (1) Administrative Manager NM-III, to function as the Executive Director of the Office of Mail Renewal, Managed Care Program (MCP), and Third-Party Health Insurance, who will :

Under the executive direction of the MAP Assistant Deputy Commissioner (ADC) of NHED, MCP, and OMR with wide latitude for independent initiative, decision making, and judgement, the Executive Director (ED) is responsible for the administration of three (3) Medical Assistance Program (MAP) divisions : the Office of Mail Renewal (OMR), the Managed Care Program (MCP), and Third-Party Health Insurance. Ensuring that the three divisions keep pace with changes relating to health care reform and anticipated program growth without causing delays or interruptions to its service delivery. The ED collaborates with the ADC in service planning, service evaluation, and policy formation, and is responsible for resolving complex service issues in the respected areas.

• Administratively responsible for planning, administering, and coordinating the operational activities of OMR, MCP, and TPHI. Ensure adherence to all local, state and federal mandated timetables, cost parameters, eligibility determination procedures, sanctioned error rates, and other agency objectives.
• Provide administrative leadership, consultation, and technical guidance to OMR, MCP, and TPHI senior and supervisory staff. Interpret policy and procedural changes to staff, and establish standards and criteria to improve the performance, quality, and productivity of the staff’s responsibility areas.
• Identify areas of vulnerability for committing fraud, and program changes through the monthly statistics and changing demographics. Ensure that the divisions keep pace with these changes to ensure continued services to its consumers. Also review progress and performance reports submitted by the senior and supervisory staff for the purpose of increasing efficiency and to better meet the needs of the public.
• Make recommendations affecting OMR, MCP, and TPHI organizational structure, major program, and automated systems operations to ensure the optimum effectiveness of the divisions. Based on the operational needs of each division, initiate personnel actions necessary to accomplish the mission of each division efficiently and effectively.
• Make recommendations to the ADC and participate in the formulation and implementation of agency program policies and procedures and evaluate proposals for policy changes impacting the operations of each division. Effectively implement policy changes ascertaining proper integration and compliance of local, state, federal, and Agency regulations.
• Oversee the coordination of the review, redesign, and / or establishment of new programs and procedures in the determination of OMR, MCP, and TPHI eligibility aimed at reducing the level of eligibility decision errors, avoiding financial / billing discrepancies to MCOs, easing administrative backlogs and deficiencies that slow down vital services to an at-risk population, and identifying possible vulnerabilities that would allow fraud. Recommend corrective actions including procedural changes to the ADC in order to achieve greater cost savings and productivity.
• Oversee special projects and studies, including quality control activities, to identify and develop approaches to resolve OMR, MCP, and TPHI program issues in the areas of personnel resources allocation, financial management and control, and management systems development and a design with a goal of ensuring quantitative and qualitative performances.
• Maintain liaison with other agencies such as the NY State Department of Health (SDOH), NY Medicaid CHOICE / MAXIMUS, Managed Care Organizations (MCOs), the Office of Medicaid Inspector General (OMIG), other MAP and HRA officials, and other governmental and private agencies / parties who are concerned with matters involving the delivery of essential services to Medicaid eligible consumers. Also responds to their inquiries and concerns related to the provision of Medicaid benefits and payments.
• Represent the divisions at committee meetings and hearings to resolve critical issues and major problems related to service delivery. Also represent each division’s interests and concerns before legislative bodies and in discussions with local, state and federal agencies.
• Responsible for the integration of divisional functions and activities with operations of other organizational components in MAP, HRA, other city departments, SDOH, and other governmental and private social services, including the implementation of medical assistance related rules and regulations.

Salary Range : $81,659 to $122,432

Work Location : 470 Vanderbilt Avenue, Brooklyn, NY, 11238

Hours / Schedule : 9 am – 5 pm

Minimum Qualifications

Preferred Skills

55a Program

This position is also open to qualified persons with a disability who are eligible for the 55-a Program. Please indicate at the top of your resume and cover letter that you would like to be considered for the position through the 55-a Program.

Public Service Loan Forgiveness

As a prospective employee of the City of New York, you may be eligible for federal loan forgiveness programs and state repayment assistance programs. For more information, please visit the U.S. Department of Education’s website at https : / / studentaid.gov / pslf / .

Residency Requirement

New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.

Additional Information

The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.

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Salary : $81,659 - $122,432