Executive Director of Medicaid Operations
NYC Department of Education - New York, NY

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Executive Director of Medicaid Operations

Tracking Code 9596 Job Description

Please Note: Position only open to internal NYC Department of Education employees.

Position Summary: The New York City Department of Education (NYCDOE) is the largest school system in the nation, with nearly 1.1 million students, approximately 135,000 employees, including almost 75,000+ teachers and an annual budget of $14.0B+. The DOE is committed to creating a system of 1,700+ great schools. Since its inception in 2003, the Children First Agenda for New York's schools has driven the DOE's work in adopting uniform, rigorous curricula for all schools, starting new small schools to increase educational options for students and transforming the structure and culture of the DOE to encourage educational excellence and the work necessary to support that goal.

The Executive Director of Medicaid Operations will have responsibility for providing overall leadership and vision for DOE’s Medicaid claiming ability in the areas of Physical Therapy, Occupational Therapy, Speech Therapy, Nursing and Counseling. S/he will also be responsible for the development and implementation of policies, practices and procedures to support the mission of the school system, as well as goals and objectives to promote the efficiency and effectiveness within the context of Medicaid work. Performs related work.

Reports to: Chief Financial Officer

Direct Reports: N/A

Key Relationships: Works closely with the Division of Academics, Performance and Support (DAPS), Division of Financial Operations (DFO), Office of School Support (OSS), Division of Students with Disabilities and English Language Learners (DSwDELL), Office of School Health (OSH), Office of the General Counsel (OGC), Office of the Auditor General (OAG), NYC Human Resources Administration (HRA), State Department of Education (SED), State Department of Health (SDH) and the Office of Management and Budget (OMB).

Responsibilities
  • Develop a project plan that explores current processes and recommend improved mechanisms and protocols to achieve budgeted Medicaid amount of $100.0M.
  • Oversee the planning, evaluation and implementation of the organization's Medicaid Claiming Process.
  • Provide overall leadership and direction, including the planning, implementation and evaluation, of the DOE’s Medicaid Claiming Process.
  • Coordinate with internal offices, including DAPS, DFO, DSwDELL, OSH, OGC and OAG on various Medicaid matters, including parent consent, prescriptions, and data management and logistics.
  • Work with external stakeholders such as HRA, SED, SDH and OMB.
  • Ensure the timely and accurate completion, maintenance and submission of all reports in the claiming process.
  • Maintain knowledge of regulatory guidelines, and recommend operational changes as needed.
  • Assess that the DOE’s current resources are adequate for meeting the requirements of SED Law Part 521 Medicaid Provider Compliance Program.
  • Create and deliver a comprehensive training program for existing and new DOE employees who are involved in any facet of the program, as well as for private providers of Medicaid eligible services, that incorporates on-line access and tracking of participants. Training includes information pertaining to the False Claims Act; Medicaid; procedures for reporting fraud, waste and mismanagement; and whistleblower protection.
  • Conduct quality assurance reviews of Medicaid claims for compliance with State Plan Amendment and Corrective Action Plans.
  • Develop reports to the Chancellor/designee and Compliance Committee on the results of quality assurance reviews, new developments in Medicaid claiming, incidences of non-compliance, recommendations and suggested remedies.
  • Assess current systems to routinely identify compliance risk areas and recommend additional safeguards, as needed.
  • Make referrals to and liaise with external and internal investigative law enforcement and auditing offices, as necessary.
  • Keep current with Medicaid developments and align training materials to comply with all regulatory requirements.
  • Assist senior leadership and executive management with other regulatory, audit and quality review functions.

Qualification Requirements:

Minimum

  • A master's degree from an accredited college in economics, finance, accounting, business or public administration, human resources management, management science, operations research, organizational behavior, industrial psychology, statistics, personnel administration, labor relations, psychology, sociology, human resources development, political science, or a closely related field, and two (2) years of satisfactory full-time professional experience in budget administration, economic or financial administration, fiscal or economic research; management or methods analysis, operations research, organizational research or program evaluation; educational, personnel or public administration, recruitment, position classification, personnel relations, labor relations, employee benefits, staff development, employment program planning/administration, labor market research, economic planning, fiscal management, or a related area, for educational program(s) and/or institution(s), 18 months of which must have been in an executive, managerial, administrative or supervisory capacity. Supervision must have included supervising staff performing professional work in the areas described above; or
  • A baccalaureate degree from an accredited college and four (4) years of satisfactory full-time professional experience as described in "1" above, including the 18 months of executive, managerial, administrative or supervisory experience described in "1" above.


  • Plus
    • Six (6) years of successful work experience in a program management role within a large organization.

    Preferred
    • Creative problem solver with the ability to perform independent, thoughtful analysis around important educational issues.
    • Well-organized and able to work under pressure, and effectively set priorities in a demanding environment.
    • Clear communicator who can make presentations to a variety of constituencies within the DOE.
    • Expert-level ability in Microsoft Excel, Access, PowerPoint, and Word.

    Salary: $111,000 - $170,000

    (Internal candidates who are selected for this position and who currently hold comparable or less senior positions within the DOE will not make less than their current salary.)

    Please include a resume and cover letter with your application.

    Applications will be accepted through March 2 5 . 2013.

    NOTE: The filling of all positions is subject to budget availability and/or grant funding.

    AN EQUAL OPPORTUNITY EMPLOYER

    It is the policy of the Department of Education of the City of New York to provide educational and employment opportunities without regard to race, color, religion, creed, ethnicity, national origin, alienage, citizenship status, age, marital status, partnership status, disability, sexual orientation, gender (sex), military status, prior record of arrest or conviction (except as permitted by law), predisposing genetic characteristics, or status as a victim of domestic violence, sexual offenses and stalking, and to maintain an environment free of harassment on any of the above-noted grounds, including sexual harassment or retaliation. Inquiries regarding compliance with this equal opportunity policy may be directed to: Office of Equal Opportunity, 65 Court Street, Room 1102, Brooklyn, New York 11201, or visit the OEO website at http://schools.nyc.gov/OEO

    Job Location New York, New York, United States Position Type Full-Time/Regular New Posting
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