Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 NY HELPS
Albany, New York
Employer: StateJobsNY
Industry: Other Professional Careers
Salary: $49363. per year
Job type: Full-Time
This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS)**
To be considered for appointment through NY HELPS, candidates must meet the open-competitive minimum qualifications for this position:
• Bachelor's degree* or higher
• Advanced placement to the Trainee 2 or Grade 18 level may be possible depending on education and experience.
*Your degree must have been awarded by a college or university accredited by a regional, national, or specialized agency recognized as an accredited agency by the U.S. Department of Education/U.S. Secretary of Education. If your degree was awarded by an educational institution outside of the United States or its territories, you must provide independent verification of equivalency. This information can be found at http://www.cs.ny.gov/jobseeker/degrees.cfm. Candidates are responsible for the evaluation fee.
Competitive Minimum Qualifications:
Current New York State Employee with one year or more of permanent or contingent-permanent competitive service, or 55 b/c service as a Medicaid Integrity Specialist 1; OR current New York State employee with one year or more of permanent or contingent-permanent service or 55 b/c service in a qualifying title and eligible for transfer under section 70.1, 70.4 or 52.6 of the Civil Service Law.
70.1 Transfer:
• For a 70.1 transfer to this title, you must have one year of permanent or contingent-permanent competitive service in a 70.1 title allocated to a salary grade 16 or above (11 or above for a Trainee 1, 12 or above for a Trainee 2).
70.4 Transfer:
• For a 70.4 transfer to this title, your current title must be within two salary grades, and either be on the PCO or be on the PATT and possess a bachelor's degree. Your score on either the PCO or PATT does not need to be reachable.
52.6 Transfer:
• For a 52.6 transfer to this title, you must have one year of permanent or contingent-permanent service in a 52.6 title allocated to a salary grade 16 or above (11 or above for a Trainee 1, 12 or above for a Trainee 2).
To determine if your current Civil Service title is eligible for transfer to this title, visit the Career Mobility GOT-IT website: Career Mobility Office " GOT-IT (ny.gov)
Appointments via transfer must not result in a second, consecutive transfer with an advancement of more than two S-grades or one M-grade.
55-b/c program appointments: For a 55 b/c appointment, you must:
• Possess the minimum qualifications for the selected title as established by the Department of Civil Service and listed on the most recent exam announcement.
• Meet the applicable minimal mental and/or physical requirements for the job (with a reasonable accommodation if necessary).
• Have a current Eligibility Letter from the NYS Department of Civil Service, www.cs.ny.gov/rp55/ and be able to provide it to the Human Resources Office upon request.
*If you are currently 55 b/c eligible and possess a bachelor's degree, we encourage you to apply for this position.
Depending on qualifications, you may be required to serve a 1 or 2-year traineeship that leads to the full level grade 18 position.
Duties Description PREFERRED QUALIFICATIONS:
Excellent verbal/written communication, analytical, organizational, and personal skills; knowledge and experience with excel and access; experience working with managed care contracts.
This position is in the Managed Care Organization Reporting Unit (MCORU) within the Division of Medicaid Investigations (DMI). Medicaid Managed Care Organizations (MMCO) are contractually obligated to refer to OMIG all identified Fraud, Waste, and Abuse referrals. OMIG is in turn contractually obligated to notify the plan within 30 days whether the referral is being returned to the plan to take action, or that the referral is being accepted by OMIG, and the plan can't take any further action. Working in this unit includes:
• Ensuring MMCO referrals are processed and assessed expeditiously, prepared for weekly internal triage with supporting claims data, and when internal or external clearance is needed, obtain clearance within the appropriate time frame so that OMIG fulfills its contractual obligations.
• Ensuring all information is tracked accurately within DMI's internal case tracking system.
• Coordinate with other internal and external stakeholders.
• Processing requests for clearance from MMCOs and coordinating within DMI and OMIG to determine if clearance may be granted.
• Communicating with MMCOs as needed.
Additional Comments Permanent, Full-Time, Competitive (for transfers and appointments off a list), Non-Competitive (for appointments through the NY HELPS Program). Trainee 1 salary starts at $49,363. Salary is non-negotiable.
**The Department of Civil Service has developed the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS), which is a streamlined program that allows appointment to this title and others without examination.
For the duration of the NY HELPS program, this title, may be filled via permanent, non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the titles for which they apply.
Benefits of Working for NYS
Generous benefits package, worth 65% of salary, including:
Holiday & Paid Time Off
• 13 paid holidays annually
• Up to 13 days of paid vacation leave annually
• Up to 5 days of paid personal leave annually
• Up to 13 days of paid sick leave annually for PEF/CSEA
Health Care Benefits
• Eligible employees and dependents can pick from a variety of affordable health insurance programs.
• Family dental and vision benefits at no additional cost
Additional Benefits
• New York State Employees' Retirement System (ERS) Membership
• NYS Deferred Compensation
• Access to NY 529 and NY ABLE College Savings Programs, as well as U.S. Savings Bonds
• Public Service Loan Forgiveness (PSLF)
And many more.
Some positions may require additional credentials or a background check to verify your identity.
Name Jenn Sichak
Telephone
Fax 518-408-0395
Email Address Recruitment@omig.ny.gov
Address
Street 800 North Pearl St
2nd Floor
City Albany
State NY
Zip Code 12204
Notes on Applying Submit resume to Jennifer Sichak, Office of the Medicaid Inspector General, 800 North Pearl St, 2nd Floor, Albany, NY 12204, or by email to Recruitment@omig.ny.gov with a subject line of MIS 1/MCORU, or by fax to (518) 408-0395, no later than September 23rd, 2024.
PLEASE NOTE: We are unable to open documents from Google Docs, Google Drive, OneDrive, Apple Pages, and/or "the cloud". Please submit resume as a Word or PDF Attachment.
To be considered for appointment through NY HELPS, candidates must meet the open-competitive minimum qualifications for this position:
• Bachelor's degree* or higher
• Advanced placement to the Trainee 2 or Grade 18 level may be possible depending on education and experience.
*Your degree must have been awarded by a college or university accredited by a regional, national, or specialized agency recognized as an accredited agency by the U.S. Department of Education/U.S. Secretary of Education. If your degree was awarded by an educational institution outside of the United States or its territories, you must provide independent verification of equivalency. This information can be found at http://www.cs.ny.gov/jobseeker/degrees.cfm. Candidates are responsible for the evaluation fee.
Competitive Minimum Qualifications:
Current New York State Employee with one year or more of permanent or contingent-permanent competitive service, or 55 b/c service as a Medicaid Integrity Specialist 1; OR current New York State employee with one year or more of permanent or contingent-permanent service or 55 b/c service in a qualifying title and eligible for transfer under section 70.1, 70.4 or 52.6 of the Civil Service Law.
70.1 Transfer:
• For a 70.1 transfer to this title, you must have one year of permanent or contingent-permanent competitive service in a 70.1 title allocated to a salary grade 16 or above (11 or above for a Trainee 1, 12 or above for a Trainee 2).
70.4 Transfer:
• For a 70.4 transfer to this title, your current title must be within two salary grades, and either be on the PCO or be on the PATT and possess a bachelor's degree. Your score on either the PCO or PATT does not need to be reachable.
52.6 Transfer:
• For a 52.6 transfer to this title, you must have one year of permanent or contingent-permanent service in a 52.6 title allocated to a salary grade 16 or above (11 or above for a Trainee 1, 12 or above for a Trainee 2).
To determine if your current Civil Service title is eligible for transfer to this title, visit the Career Mobility GOT-IT website: Career Mobility Office " GOT-IT (ny.gov)
Appointments via transfer must not result in a second, consecutive transfer with an advancement of more than two S-grades or one M-grade.
55-b/c program appointments: For a 55 b/c appointment, you must:
• Possess the minimum qualifications for the selected title as established by the Department of Civil Service and listed on the most recent exam announcement.
• Meet the applicable minimal mental and/or physical requirements for the job (with a reasonable accommodation if necessary).
• Have a current Eligibility Letter from the NYS Department of Civil Service, www.cs.ny.gov/rp55/ and be able to provide it to the Human Resources Office upon request.
*If you are currently 55 b/c eligible and possess a bachelor's degree, we encourage you to apply for this position.
Depending on qualifications, you may be required to serve a 1 or 2-year traineeship that leads to the full level grade 18 position.
Duties Description PREFERRED QUALIFICATIONS:
Excellent verbal/written communication, analytical, organizational, and personal skills; knowledge and experience with excel and access; experience working with managed care contracts.
This position is in the Managed Care Organization Reporting Unit (MCORU) within the Division of Medicaid Investigations (DMI). Medicaid Managed Care Organizations (MMCO) are contractually obligated to refer to OMIG all identified Fraud, Waste, and Abuse referrals. OMIG is in turn contractually obligated to notify the plan within 30 days whether the referral is being returned to the plan to take action, or that the referral is being accepted by OMIG, and the plan can't take any further action. Working in this unit includes:
• Ensuring MMCO referrals are processed and assessed expeditiously, prepared for weekly internal triage with supporting claims data, and when internal or external clearance is needed, obtain clearance within the appropriate time frame so that OMIG fulfills its contractual obligations.
• Ensuring all information is tracked accurately within DMI's internal case tracking system.
• Coordinate with other internal and external stakeholders.
• Processing requests for clearance from MMCOs and coordinating within DMI and OMIG to determine if clearance may be granted.
• Communicating with MMCOs as needed.
Additional Comments Permanent, Full-Time, Competitive (for transfers and appointments off a list), Non-Competitive (for appointments through the NY HELPS Program). Trainee 1 salary starts at $49,363. Salary is non-negotiable.
**The Department of Civil Service has developed the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS), which is a streamlined program that allows appointment to this title and others without examination.
For the duration of the NY HELPS program, this title, may be filled via permanent, non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the titles for which they apply.
Benefits of Working for NYS
Generous benefits package, worth 65% of salary, including:
Holiday & Paid Time Off
• 13 paid holidays annually
• Up to 13 days of paid vacation leave annually
• Up to 5 days of paid personal leave annually
• Up to 13 days of paid sick leave annually for PEF/CSEA
Health Care Benefits
• Eligible employees and dependents can pick from a variety of affordable health insurance programs.
• Family dental and vision benefits at no additional cost
Additional Benefits
• New York State Employees' Retirement System (ERS) Membership
• NYS Deferred Compensation
• Access to NY 529 and NY ABLE College Savings Programs, as well as U.S. Savings Bonds
• Public Service Loan Forgiveness (PSLF)
And many more.
Some positions may require additional credentials or a background check to verify your identity.
Name Jenn Sichak
Telephone
Fax 518-408-0395
Email Address Recruitment@omig.ny.gov
Address
Street 800 North Pearl St
2nd Floor
City Albany
State NY
Zip Code 12204
Notes on Applying Submit resume to Jennifer Sichak, Office of the Medicaid Inspector General, 800 North Pearl St, 2nd Floor, Albany, NY 12204, or by email to Recruitment@omig.ny.gov with a subject line of MIS 1/MCORU, or by fax to (518) 408-0395, no later than September 23rd, 2024.
PLEASE NOTE: We are unable to open documents from Google Docs, Google Drive, OneDrive, Apple Pages, and/or "the cloud". Please submit resume as a Word or PDF Attachment.
Created: 2024-09-08
Reference: 167022
Country: United States
State: New York
City: Albany
ZIP: 12208
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