NY HELPYes

AgencyMedicaid Inspector General, NYS Office of the

TitleMedicaid Integrity Specialist 1/Trainee 1/Trainee 2 (NY HELPS)

Occupational CategoryOther Professional Careers

Salary Grade18

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

Salary RangeFrom $53764 to $85138 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Non-competitive Class

Travel Percentage 5%

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

County New York

Street Address 90 Church Street, 14th Floor

City New York City

StateNY

Zip Code10007

Duties Description Duties include:
• Conduct compliance program reviews using established procedures and protocols.
• Analyze data and arguments to make well-reasoned determinations for Medicaid managed care reviews.
• Apply Medicaid policy, regulations and Medicaid managed care contracts to reviews.
• Prepare well-written and accurate audit reports using prescribed OMIG agency formats and templates.
• Respond to routine correspondence and inquiries, research or gather additional information as needed.
• Be proficient in using Excel, Health Commerce System, FACTS, eMedNY and other applications used to obtain information.
• Update relevant audit-tracking systems.

Note: Travel will be minimal and will be provided with advanced notice to attend onboardings and trainings.

Minimum Qualifications GENERAL PUBLIC: To be considered for appointment through NY HELPS, candidates must meet the open-competitive minimum qualifications for this position.

Appointment to the Trainee 1 level requires:
• Four years of experience* in the promotion of Medicaid program integrity and appropriate delivery and utilization of Medicaid programs and services; OR
• Associate’s degree* AND two years of experience; OR
• Bachelor’s degree*

* Medicaid programs and services include: educating, assisting, and monitoring compliance with program regulations and obligations; developing, clarifying, and ensuring implementation of program requirements; collecting and analyzing data; evaluating and assessing appropriateness of provider or recipient participation in the Medicaid program or the appropriateness of billing or utilization of service; or developing referrals for further action or recommendations for corrective action.

** Advanced placement to the Trainee 2 or Grade 18 level may be possible depending on education and experience. It is essential that candidates clearly and concisely indicate exactly how they meet the above minimum qualifications in their resume. Failure to show how you meet the minimum qualifications above may result in disqualifications and removal from consideration.

*Your degree must have been awarded by a college or university accredited by 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.

CURRENT NYS EMPLOYEES- 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.

PREFERRED QUALIFICATIONS: Works well as part of a team and independently; demonstrates strong critical thinking skills, ability to multitask, attention to detail, and excellent interpersonal skills.

Excellent written and oral communication, including grammar and editing skills; critical, independent thinking, and analytical skills; excellent reading comprehension.

Proficiency with Microsoft Office Suite and ability to learn new data systems.

Familiarity with the Medicaid Managed Care/Family Health Plus/HIV Special Needs Plan Contract and other federal and state laws and regulations that govern Managed Care Organizations.

Additional Comments Permanent, Full-Time, Competitive (for transfer and appointments off a list), Non-Competitive (for appointments through the NY HELPS Program).

SALARIES ARE NON-NEGOTIABLE:
Position is eligible for location pay of $4,000
Trainee 1 salary: $53,764
Trainee 2 salary: $59,994
G-18 salary: $66,951

**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.

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.

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.

City Albany

State NY

Zip Code 12204

Notes on ApplyingAPPLICATION: 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# 204390, TITLE-MIS1, and LOCATION- NYC in the subject heading to apply to this position.

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. (33604)