Review Vacancy
AgencyMental Health, Office of
TitleMedicaid Compliance Officer, Central Office
Occupational CategoryOther Professional Careers
Bargaining UnitM/C - Management / Confidential (Unrepresented)
Salary RangeFrom $0 to $112660 Annually
Minimum Qualifications • 5+ years of experience with health care compliance programs and requirements
• Knowledge of New York State’s Mandatory Medicaid Compliance Program
• Knowledge of OMH operations
• Knowledge of Medicare, Medicaid requirements
• Prior management experience
• Ability to work independently
Duties Description The Office of Mental Health (OMH) is seeking a qualified candidate for the exempt position of Director Internal Audit (Medicaid Compliance Officer). Under the general direction of the Deputy Commissioner of Quality Management, the Director of Internal Audit (Medicaid Compliance Officer) oversees all activities related to the development, implementation, maintenance of and adherence to the Medicaid Compliance Program. The position has the function of directing employees in regulatory compliance; maintaining an effective compliance program; serving as a primary resource for Medicare/Medicaid reimbursement information; and acting as a consulting resource for reimbursement and regulatory issues. Essential duties and responsibilities of this position include, but are not limited to:
Advising and directing employees in regulatory compliance. This includes the following responsibilities:
• Disseminating information to and educating of 15,000+ employees regarding a broad spectrum of compliance-related topics;
• Maintaining a current working knowledge of Federal and State regulations and policies as they affect OMH through routine review of various resources (e.g., CMS manuals, DMERC manuals, Federal Register notices, applicable government and/or industry related internet information sites, multiple stated Medicaid manuals, State Board of Pharmacy Regulations);
• Functioning as a key OMH representative/liaison in meetings with CMS, Medicare carriers, Medicaid Agencies, other federal/state agencies, and industry organizations regarding regulatory policy;
• Providing education and training about actual, proposed, or pending legislation and regulations that affect operations and identifying operational obstacles to compliance, and working with other employees to identify and implement solutions, and
• Reporting to leadership on compliance-related matters as appropriate.
Maintaining the effectiveness of the Compliance Program. This includes oversight and monitoring of the Compliance Program through:
• Creation/revision of applicable policies and procedures that describe the compliance program expectations;
• Identify areas of risk for the organization and conduct or direct risk assessments;
• Measurement of compliance by conducting routine and/or focused internal reviews or audits of policy/procedure adherence and report findings;
• Formulate plans of corrective action for implementation where vulnerabilities are identified, and monitor progress;
• Communicate to agency management any identified organizational and operational problems and their assessed implication;
• Development, coordination and participation in routine multifaceted educational and training programs that focus on the elements of the Compliance Program thus striving to ensure that all appropriate employees and management are knowledgeable of, and comply with, pertinent Federal and State Health care program requirements; and
• Periodic revision of the Compliance Program in light of changes in the organization's needs, and in the statutes, rules, regulations, and requirements of Federal and State health care programs.
Additional Comments To be considered for this position, interested candidates should email a cover letter and resume in Microsoft Word or PDF format to omhhrm@omh.ny.gov. Please include the title of the position, location, and the vacancy # number in the subject line of your email when applying.
You are advised that, should you accept a job offer with the Office of Mental Health, you may be required to be fingerprinted and pay a fingerprint fee.
Some positions may require additional credentials or a background check to verify your identity.