Health Care Surveyor ; Nursing); NY HELPS
Listed on 2026-10-11
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Healthcare
Healthcare Management
Location: City of Albany
Duties Description
The Office of Health Insurance Programs, within the Division of Medical & Dental Directors, in the Bureau for Children with Medical Complexity is seeking a The Health Care Surveyor 4 (Nursing) position. The Bureau for Children with Medical Complexity (BCMC) is responsible for addressing the needs of children with medical complexity and overseeing Medicaid services that support this population. The Health Care Surveyor 4 (Nursing) will serve as a unit manager within BCMC and will oversee the Medically Fragile Waiver Enrollment Unit and the Environmental Modification, Vehicle Modification, Assistive Technology, and Financial Management Services (EMOD/VMOD/AT/FMS) Unit.
Duties include:
Oversee day-to-day operations of the assigned units, including staff, workloads, and program activities;
Supervise nursing and clinical review staff responsible for waiver enrollment, service reviews, and regulatory and quality assurance activities;
Oversee clinical reviews, complaints, incidents, prior approvals, and claims review activities;
Ensure compliance with applicable federal and state requirements, Medicaid policies, and standards of clinical practice;
Use program data and feedback from children and families, healthcare providers, and other stakeholders to identify needs and opportunities for program development and quality improvement;
Lead or support innovative approaches to improve access, service delivery, consistency, and outcomes for medically fragile children;
Interpret and provide guidance on program policies, procedures, and requirements;
Coordinate with healthcare providers, vendors, contractors, case management entities, OHIP divisions, and other department offices to support program operations and resolve issues;
Monitor provider and vendor performance; and assist with the development and implementation of policies and procedures related to the assigned programs.
The Office of Health Insurance Programs, within the Division of Medical & Dental Directors, in the Bureau for Children with Medical Complexity is seeking a The Health Care Surveyor 4 (Nursing) position. The Bureau for Children with Medical Complexity (BCMC) is responsible for addressing the needs of children with medical complexity and overseeing Medicaid services that support this population. The Health Care Surveyor 4 (Nursing) will serve as a unit manager within BCMC and will oversee the Medically Fragile Waiver Enrollment Unit and the Environmental Modification, Vehicle Modification, Assistive Technology, and Financial Management Services (EMOD/VMOD/AT/FMS) Unit.
Duties include:
Oversee day-to-day operations of the assigned units, including staff, workloads, and program activities;
Supervise nursing and clinical review staff responsible for waiver enrollment, service reviews, and regulatory and quality assurance activities;
Oversee clinical reviews, complaints, incidents, prior approvals, and claims review activities;
Ensure compliance with applicable federal and state requirements, Medicaid policies, and standards of clinical practice;
Use program data and feedback from children and families, healthcare providers, and other stakeholders to identify needs and opportunities for program development and quality improvement;
Lead or support innovative approaches to improve access, service delivery, consistency, and outcomes for medically fragile children;
Interpret and provide guidance on program policies, procedures, and requirements;
Coordinate with healthcare providers, vendors, contractors, case management entities, OHIP divisions, and other department offices to support program operations and resolve issues;
Monitor provider and vendor performance; and assist with the development and implementation of policies and procedures related to the assigned programs.
Minimum Qualifications
Permanent Transfer Candidates:
Current NYS Department of Health employee with one year of permanent or contingent-permanent, competitive, service as a Health Care Surveyor 4 (Nursing) G25 and eligible to transfer under Section 70.1 of the NYS Civil Service Law.
Non-competitive via HELPS:
Possession of a license and current registration as a registered professional nurse in New York State and three years of post-licensure, specialized professional administrative or professional clinical experience. One year of the experience must have been at a supervisory level.
Substitution: A master's degree in nursing may substitute…
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