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Minimum Qualifications Permanent candidates must currently be a permanent DDPS 1 OR be reachable on the current Civil Service eligible list OR be eligible for transfer under Section 70.1 of the Civil Service Law.
Duties Description The Office for People With Developmental Disabilities (OPWDD) provides high-quality, person centered services, supports and advocacy to approximately 130,000+ individuals with developmental disabilities in New York State. We are guided in our interactions with the people we serve and each other by compassion, dignity, diversity, excellence and honesty.
As a condition of Medicaid participation, certain laws require OPWDD as a service provider (state operations) to adopt and implement an effective compliance program to identify areas of Medicaid fraud, waste, and abuse to assist with the integrity of the Medicaid program. The OPWDD State Operations Offices have a responsibility to ensure overall Medicaid compliance within their regions.
The DDPS1 (DDSO Medicaid Liaison) will report to the SOO Director or their designee, and will act as point person with the DDSO Management, and various Central Office Units including the Medicaid Compliance Unit. The incumbents will perform professional, administrative, training, and analytical duties related to district compliance in order to assist with the integrity of the Medicaid program and to mitigate agency revenue losses on claims billed to Medicaid.
•Serve as a local resource and assist in identifying, evaluating and mitigating Medicaid Compliance issues;
•Generally, act as point person with various Central Office Units on billing and claiming issues or audits, allegations of Medicaid fraud, waste, & abuse allegations, or other areas as needed;
•Review claim samples provided by the Office of Audit Services, and corresponding service documentation, for billing compliance quarterly;
•Record results of claim reviews and analyze those results to identify locations and staff where systemic trends of deficient claims indicate additional training needs, proactive measures and/or improved internal controls;
•Evaluate potential or actual non-compliance identified; investigate the frequency, causes, and financial impact and, where warranted, prepare and submit self-disclosure reporting forms;
•Communicate with the SOO Director and DDSO staff on issues within the district including potential fraud or self-disclosures;
•Develop, monitor, record, or facilitate corrective action plans on issues related to compliance;
•Conduct, or assist with, training and education on Medicaid Compliance issues and expectations;
•Participate in statewide meetings and individual meetings with Central Office staff;
•Assist in development of policies and procedures, surveys, reports or forms, as needed;
•Travel to geographic areas within your district; may involve occasional travel to Central Office.
Preferred Knowledge, Skills, or Abilities:
•Microsoft Office Suite skills (Word, Excel, PowerPoint) and Access;
•Analytical and administrative skillsets;
•Presentation and training experience;
•Familiarity with HCBS waiver service programs and Waiver service documentation;
•Familiarity with OPWDD Administrative Memorandums (ADM’s), and regulations;
•Ability to work well independently and in a team environment.
Some positions may require additional credentials or a background check to verify your identity.
Notes on ApplyingAPPLICATION PROCEDURE: Submit cover letter and resume by 8/22/18 to:
Taconic DDSOO – Human Resources
25 Center Circle
Wassaic, NY 12592
Phone: 845-877-6821 Extension 3367
Please reference the above EOA #2018-279 in all correspondence.
•Preference will be given to OPWDD employees impacted by closures. If you are being impacted by closure, please indicate this on your resume/cover letter.
•In order to be eligible for appointment and to maintain employment, you cannot be listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). If you are appointed and subsequently listed as an excluded individual or entity on any of these lists (or excluded from any other Federal or Federally assisted program), you may be terminated from your employment.
•OPWDD is an Equal Opportunity/Affirmative Action Employer