NY HELP Yes
Agency Medicaid Inspector General, NYS Office of the
Title Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 (NY HELPS)
Occupational Category No Preference
Salary Grade 18
Bargaining Unit PS&T - Professional, Scientific, and Technical (PEF)
Salary Range From $53764 to $85138 Annually
Employment Type Full-Time
Appointment Type Permanent
Jurisdictional Class Non-competitive Class
Travel Percentage 0%
Workweek Mon-Fri
Hours Per Week 37.5
Workday
From 8 AM
To 5 PM
Flextime allowed? No
Mandatory overtime? No
Compressed workweek allowed? No
Telecommuting allowed? Yes
County Albany
Street Address 800 North Pearl St
City Albany
State NY
Zip Code 12204
Duties Description PREFERRED QUALIFICATIONS: Preferred candidates will have strong organizational and time management skills; be able to handle multiple competing priorities; have attention to detail; and excellent written and verbal communication skills. Working knowledge of software systems including eMedNY and FACTS is preferred. A willingness to learn.The Medicaid Integrity Specialist 1 position will support the Division of System Utilization and Review, Bureau of Third Party & Payment Oversight, RAC unit. Duties of the position will include, but may not be limited to:- Collaborating closely with the Recovery Audit Contractor (RAC) to facilitate reviews through the new Draft Audit Report (DAR) and Final Audit Report (FAR) procedures.- Contacting appropriate internal OMIG stakeholders and external stakeholders for addressing RAC's needs, questions, vetting of RAC audits, and/or following-up on outstanding audits.- Aiding in the research and preparation of various documents related to the policies and processes of the RAC Unit.- Open FACTS cases and maintain/update throughout the DAR/FAR process.- Vet providers and Managed Care plans.- Supporting the Contractor in the preparation and distribution of each DAR and FAR, as well as monitoring the status of each issued report.- Tracking various repayment collection methods from providers for each DAR/FAR, entering relevant repayment information into the OMIG's data management tracking systems, and updating audit reports of repayments, as deemed appropriate. - Create weekly reports for the RAC contractor for all open projects.- Create ad-hoc reports in OMIG's data management tracking system.- Analyzing and vetting submitted claim data by the Contractor for accuracy and to prevent intra-agency duplication prior to the issuance of each DAR/FAR.- Utilize Access, Excel, and SQL Developer to analyze and verify claim data in monthly data feeds, OMIG projects, and contractor audits. - Assist in RAC scenario approvals and vetting throughout the agency.- Responding to inquiries from providers and attorneys concerning both contractor and OMIG audits.- Coordinating with contractors, various divisions, and the provider community.- Collaborating with the Office of Counsel on the preparation of documents and hearings.- Verifying and analyzing OSC methodologies.
Minimum Qualifications This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS)*To be considered for appointment through NY HELPS, candidates must meet the open-competitive minimum qualifications for this position: - Bachelor's degree or higher- 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 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. 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. 70.1 Transfer: - For a 70.1 transfer to this title, you must have one year of permanent or contingent-permanent competitive service in a 70.1 title allocated to a salary grade 16 or above (11 or above for a Trainee 1, 12 or above for a Trainee 2).70.4 Transfer:- For a 70.4 transfer to this title, your current title must be within two salary grades, and either be on the PCO or be on the PATT and possess a bachelor's degree. Your score on either the PCO or PATT does not need to be reachable. 52.6 Transfer: - For a 52.6 transfer to this title, you must have one year of permanent or contingent-permanent service in a 52.6 title allocated to a salary grade 16 or above (11 or above for a Trainee 1, 12 or above for a Trainee 2).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)Appointments via transfer must not result in a second, consecutive transfer with an advancement of more than two S-grades or one M-grade.55-b/c program appointments: For a 55 b/c appointment, you must: - Possess the minimum qualifications for the selected title as established by the Department of Civil Service and listed on the most recent exam announcement. - Meet the applicable minimal mental and/or physical requirements for the job (with a reasonable accommodation if necessary). - Have a current Eligibility Letter from the NYS Department of Civil Service, www.cs.ny.gov/rp55/ and be able to provide it to the Human Resources Office upon request.If you are currently 55 b/c eligible and possess a bachelor's degree, we encourage you to apply for this position.Depending on qualifications, you may be required to serve a 1 or 2-year traineeship that leads to the full level grade 18 position.
Additional Comments 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 $53,764. 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.
Some positions may require additional credentials or a background check to verify your identity.
Name Tess McCaffrey
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 Submit resume to Tess McCaffrey, Office of the Medicaid Inspector General, 800 North Pearl St, 2nd Floor, Albany, NY 12204, OR by email to Recruitment@omig.ny.gov with a subject line of MIS 1/RAC, or item number 22102, OR by fax to (518) 408-0395.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.
