Position Information

NY HELPYes

AgencyMedicaid Inspector General, NYS Office of the

TitleHealth Care Surveyor 3 (Nursing) 2 Positions

Occupational CategoryOther Professional Careers

Salary Grade22

Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)

Salary RangeFrom $113178 to $124230 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Non-competitive Class

Travel Percentage 0%

Schedule

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? Yes

Telecommuting allowed? Yes

Location

County Albany

Street Address 800 North Pearl St

City Albany

StateNY

Zip Code12204

Job Specifics

Duties Description The Division of Medicaid Investigations (DMI) ensures the integrity of the Medicaid program by conducting prepayment claims review, investigations, recovering over payments, and implementing administrative sanctions and can refer for criminal prosecution.

The Health Care Surveyor 3 will support the Medical Prepayment Claims Review team within the Bureau of Payment Controls & Monitoring in DMI.

The Bureau of Payment Controls & Monitoring is a multi-functional team comprised of several Prepayment Claims Review Teams (Medical, Dental and Transportation), a Dental Investigative Team and a Dental Audit Team. The bureau is a high production unit involving thousands of incoming pended claims, thousands of processed claims, hundreds of active prepayment claim review cases with a need to track all cases and claims adjudicated in the eMedNY claims processing system.

The duties of the position include, but are not limited to:
• Assisting in targeting and data review.
• Performing review and processing of pended claims, assuring appropriate determinations.
• Performing research and data collection to support prepayment review actions.
• Assisting in building criteria to capture and process medical claims.
• Performing high level chart review.
• Utilizing professional judgment to document and critique the quality of care provided to the Medicaid patients of identified Medicaid Providers.
• Preparing Provider review summaries and referrals for action based on NYS Medicaid Rules, Regulations, Policies, and Guidelines for each specific category of service.
• Communicating orally and in writing with Medicaid providers, OMIG legal staff, independent peers, other agencies, the provider community, and their legal counsel as necessary.
• Research NYS Medicaid laws, rules, regulations, provider manuals, updates, and policy to keep current on NYS Medicaid policies and billing procedures

This is a supervisory position. The HCS 3 will supervise one to two HCS 2 positions.
• Supervisory duties include, but are not limited to:
• Assigning/delegating tasks
• Training staff
• Reviewing staff work for quality and completion
• Mentoring staff in their state career

Minimum Qualifications Permanent Transfer candidates: Current New York State employee with one year of permanent or contingent-permanent service as a Health Care Surveyor 3 Nursing, SG-22.

Non-Competitive NY HELPS Qualifications:
License and current NYS registration as a Professional Nurse and three years of post-licensure, specialized professional administrative or professional clinical experience.

Qualifying health facilities and programs include hospitals, nursing homes, adult homes, ambulatory care facilities, managed care organizations, psychiatric centers, diagnostic and treatment clinics, home health agencies, assisted living facilities, hospice, renal dialysis units, alcoholism and substance abuse treatment facilities, developmental centers, and community-based programs for the mentally ill and developmentally disabled.

Experience as an RN in a private doctor’s office or group practice, or as a school nurse is NOT considered qualifying.

Substitution: A bachelor’s degree in nursing may substitute for one year of post-licensure clinical nursing experience; a master’s degree in nursing may substitute for two years of post-licensure clinical nursing experience.

PREFERRED QUALIFICATIONS:

Experience in utilization review. Experience in the insurance industry and/or Medicaid.

Additional Comments Permanent, non-competitive, full-time. Free parking available. Current licensure and registration to practice as a professional Nurse in New York State is necessary for continued employment as a Health Care Surveyor 3 Nursing. Action will be taken to remove you from your position if you fail to maintain licensure and registration.

*Posted salary range includes statutory hiring rate at Step 4 and job rate for PS&T Grade 22 ($82,326 - $104,230) and an additional Geographic Pay Differential of $20,000. Starting salary for non-NYS Employees 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.

Some positions may require additional credentials or a background check to verify your identity.

How to Apply

Name Jenn S.

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 ApplyingSubmit resume to Jenn S., by email to Recruitment@omig.ny.gov with a subject line of HCSN 3, no later than April 9th, 2026.

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.

OMIG does not participate in E-Verify and does not sponsor visa applications.


The Office of the Medicaid Inspector General is proud to be an equal opportunity employer. We encourage those with unique backgrounds and contributions such as education, culture, ethnicity, race, sex, gender identity and expression, nation of origin, age, languages spoken, veteran’s status, color, religion, disability, sexual orientation, and beliefs to apply.

We provide reasonable and religious accommodations for any part of the application and hiring process. If you have a disability or special need that requires accommodation, please send a request to RARequest@omig.ny.gov.