Department of Civil Service

Health and Human Services

Salary Range

NYC Metro - From $66,195 to $83,335
Rest of State - From $63,108 to $80,248

(Salary may differ from what is listed for an agency and/or location. See HELP job postings for specific salary.)

Career Ladder Information

Below is a listing of titles that are most commonly used as steps for upward mobility for this title series.

As a Medical Assistance Specialist 1, you would be assigned duties related to the administration of Medicaid or other public health insurance programs. You would provide technical assistance to stakeholders in developing operational procedures, instructions, and guidelines to support the implementation of enrollment and eligibility activities, and ensure operational compliance; review and assist in implementing policy and regulatory changes; review training materials; review eligibility determinations for appropriateness; perform program reviews of Medicaid providers, demonstration projects, and automated systems; and assist in the preparation and evaluation of requests for proposals related to public health insurance programs.

• Department of Health

Either 1: Six years of qualifying experience;

Or 2: an Associate's degree AND four years of qualifying experience;

Or 3: a Bachelor's or higher degree AND two years of qualifying experience.

Qualifying experience: For the purposes of this examination, qualifying experience is performing one or more of the following activities in a health care delivery system including health care facilities; federal, State, or local health care agencies; hospitals; Medicaid programs; and/or other public or private health insurance programs:

• Developing public or private health related policy.
• Analyzing AND interpreting public or private health related policy to assist consumers.
• Determining or reviewing financial eligibility for healthcare or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations.
• Establishing mechanisms for the reimbursement and financing of health care services, including rate-setting, development of capitation reimbursement methodologies, and development of fee schedules.
• Performing utilization review of requests for medical treatment including prior approval or authorization activities, adjudication of claims for payment and/or provider credentialing.
• Conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations.