RN

**Details****Client Name:** NYS DOH -OHIP (Office of Health Insurance Program)**Job Type:** Local**Position Urgency** Normal**Offering** Nursing**Profession** RN**Specialty** Complaint Intake Reviewer**Job ID** 17368852**Job Title** RN**Shift Details****Shift** 08:00 AM - 04:30 PM**Shifts Per Week** 5**scheduledHrs_1** 40.0**Job Order Details****Start Date** 2026-04-16**End Date** 2028-04-16**Duration** 104 Week(s)**Float Required** No**Call Required** No**Job Description****RN-** **Office of Health Insurance Programs (OHIP)****Division of Program Development and Management** **(DPDM)****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 develop expertise in HCBS Children's Waiver eligibility and enrollment and use their clinical and program knowledge to conduct HCBS eligibility determination assessments for Waiver applicants and enroll eligible participants. The incumbent will update and provide program education and guidance materials, as needed. The incumbent will also assist with analyzing current processes and reporting practices, Medicaid policy development, implementation and oversight.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. In addition, 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** .+ Provide clinical expertise and input on policies, procedures and decisions related to HCBS eligibility and enrollment, and other program areas as assigned.+ Conduct HCBS eligibility determinations assessments for Waiver applicants and enroll eligible participants. This includes managing referrals, providing assistance and program education, conducting initial screenings, gathering assessments information from the applicants family and providers, determining eligibility, enrolling participants and transferring participants to their choice of Children's Health Home.+ Monitor and analyze records and feedback to provide updates on HCBS eligibility and enrollment status to leadership.+ 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.+ Other activities as may be deemed necessary in response to the changing needs of OHIP.**Additional Skill Level, Experience or Other Requirements:****Qualifications:** **Bachelor's Degree and current NYS license as a registered professional nurse, 6 years of clinical healthcare experience**Annual Salary: $114,400**Client Details****Client Type** Commercial**Address** 875 Central Ave**City** Albany**State** NYEGA Associates, LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.