Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 NY HELPS

GENERAL PUBLIC CANDIDATES: Possession of a bachelor's degree* or higher. No experience is required for appointment as a Trainee 1.
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 accrediting agency by the U.S. Department of Education/U.S. Secretary of Education. If your degree was awarded by an educational institution outside 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.

CURRENT NYS EMPLOYEES:
New York State employees with one year of permanent competitive service in a title deemed eligible for transfer under Section 52.6 or 70.1 of the Civil Service Law.

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)

PREFERRED QUALIFICATIONS: Proficiency with Microsoft Office Suite, Familiarity with the Medicaid program, and/or knowledge of/willingness to learn Structured Query Language (SQL).

Duties Description New York State leads the nation in developing a robust culture of Medicaid program integrity and healthcare compliance. Formed in 2006 to more efficiently use resources dedicated to fighting fraud, waste, and abuse, we are a small agency with a big impact! To fulfill its mission, the Office of the Medicaid Inspector General (OMIG) performs audits, investigations, and reviews of Medicaid services and providers and works with other federal and state agencies that have regulatory oversight or law enforcement powers. Each year, the agency has identified or recovered billions of dollars in cost avoidance and recoveries to offset Medicaid program costs. OMIG staff primarily work on Medicaid program integrity functions. These positions include auditors, investigators, nurses, data analysts, pharmacists, other clinical/medical professionals, compliance specialists, program administrators/managers, and persons providing legal, technological, and administrative support, in seven offices across the State.
For more information on the NYS Office of the Medicaid Inspector General's Mission, please visit: https://omig.ny.gov/about-us/about-omig

Duties include:
Reporting directly to an audit supervisor, this Medicaid Integrity Specialist Trainee will join the Managed Care Enrollment and Eligibility Unit to have the opportunity to start or grow their state career in a collaborative, team-oriented environment. Over the course of a traineeship, the candidate will learn to use databases and software programs available for Medicaid research, including SQL Developer and eMedNY, to aid in the development of Medicaid managed care audits; analyze data and make well-reasoned determinations for Medicaid managed care audits, including match-based audits relating to PARIS Match, deceased enrollees, and other retroactive disenrollment scenarios; learn and apply Medicaid policy, regulations, and Medicaid managed care contracts to audits; prepare well-written and accurate audit reports, and correspond professionally within and outside the agency; oversee mail-out recovery projects, including monitoring and evaluating responses from providers, updating relevant audit-tracking systems, and documenting any adjustments as necessary; conduct research into existing and emerging trends in Medicaid managed care; work well as part of a team and independently; and demonstrate strong critical thinking skills, the ability to multitask, attention to detail, and excellent interpersonal skills.

Additional Comments FREE PARKING

NOTE ON TELECOMMUTING: OMIG employees may be approved for a maximum of 50% telecommuting, however, they are required to apply and obtain approval through management in accordance with OMIG's Telecommuting Program Guidelines.

Specific hours for each position to be discussed at time of interview.

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 Melissa H

Telephone

Fax

Email Address Recruitment@omig.ny.gov

Address

Street 800 North Pearl St

2nd Floor

City Albany

State NY

Zip Code 12204

Notes on Applying APPLICATION: Qualified candidates should send a cover letter and resume by email to Recruitment@omig.ny.gov or by fax to (518) 408-0395. Indicate the VACANCY ID #, TITLE-MIS 1 DMA, and LOCATION in the subject heading for the position you are applying to. (31506)

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.