Contract Management Specialist 2 Health Benefit Ex

Grade 23

New York State has approximately 13 positions* in this title statewide. You may view a breakdown of positions by county. This position exists in Health, Department of. View links to all New York State agencies including agencies that have this title. For more information, New York State employees can contact the Career Mobility Office at (518) 485-6199 or (800) 553-1322. If you are not a current New York State employee, you can use the Department of Civil Service Web site to explore possible employment opportunities.

*The number of positions is approximate and represents the number of positions established (both filled and vacant); it is not an indication or reference to position type or duration, or intent to be filled. If you are viewing a trainee title, please note this number reflects the number of positions established at the journey level. Agencies may fill at the trainee level(s) or at the journey level based on employee qualifications. GOT-IT does not provide information on any job postings or job availability. For information on current job postings, please visit State Jobs NY. You may also visit specific New York State Agency websites for information about an agency and its job opportunities.

Career Ladder

There is currently no Career Ladder information available for this title.

Summary of Job Description

As a Contract Management Specialist 2 (Health Benefit Exchange), you would:

Review applications requesting acceptance as certified Marketplace health plans to verify programmatic correctness, adherence to federal and State policy, compatibility with NYSOH goals, and health plan solicitation requirements.

Ensure Marketplace health plans comply with the certification standards contained in federal regulations at 45 CFR[1] 156, including standards relating to licensure, service area, network adequacy, essential community providers, marketing, and benefit design.

Ensure Marketplace health plans meet actuarial value and essential health benefit standards in accordance with applicable regulations and guidance.

Ensure cost-sharing limitations are in place for each plan.

Review plans to ensure standard plans are being offered at each level, when required; and verify that non-standard plans adhere to actuarial value, essential benefit, and solicitation requirements.

Work with health plans to ensure that all participation requirements are met and there is adequate participation in both the individual and Small Business Health Plan Marketplace.

Monitor Marketplace health plans for evidence of ongoing compliance with certification requirements, as well as compliance with NYSOH processes, procedures, requirements, and interfaces.

Collaborate with staff at the Department of Financial Services on issues related to regulatory compliance and to ensure the accuracy of information available to consumers through the website, member subscriber agreements, handbooks, and plan comparisons.

As a subject matter expert:

Define programmatic business rules related to health insurance coverage to be used in the development, testing, implementation, and refinement of information technology systems, including the Marketplace website and information exchange with health plans participating in the Marketplace.

Develop, vet, and implement protocols and standards to ensure that health plan provider networks are current, accurate, and meet adequacy standards; resolve deficiencies as they arise; serve as subject matter expert on the design or redesign of information technology systems to collect, report, and display provider affiliations with health plans.

Develop training curriculum and resources for customer service representatives, in-person assistors, and staff on the health plans and benefit variations offered on the Marketplace, provider network comparisons, cost-sharing variations, and premium comparisons.

May supervise subordinate staff.

View the classification standard for this title, on the Classification and Compensation webpage.

The NYS Title and Salary Plan provides additional information regarding other titles. If there is a classification standard available there will be a link under the column labeled STD. NO. If no link is available there is no classification standard available at this time for that title.

Summary of Minimum Qualifications

There is currently no Min Qual details available for this title.

For informational purposes only, click on the examination number(s) listed below to see the current or previous examination(s) that are used to fill this title.

How to Apply

When this examination is scheduled to be held, the announcement can be found on the Department of Civil Service, Examination Announcements web page. If you do not see an examination currently scheduled please check back on a monthly basis or sign up for announcement notification by email so that you will automatically be notified when new examinations are being offered.

Career Mobility

Career mobility is not just limited to the titles in the Career Ladder, above. Additional movement may be achieved through other examinations, additional education and/or work experience or transfer opportunities. For additional information or clarification of transfer determinations, current State employees should contact the Career Mobility Office. Visit ELMS Online to view established open-competitive, promotion, and transition eligible lists. If you are not a current New York State employee, see Employment Opportunities with New York State and find out how to become a New York State employee.

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