What are the responsibilities and job description for the Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 NY HELPS position at New York State Office of the Medicaid Inspector General?
Description
Duties Description
New York State leads the nation in developing a robust culture of Medicaid program integrity and healthcare compliance. Formed in 2006 to more efficiently use resources dedicated to fighting fraud, waste, and abuse, we are a small agency with a big impact! To fulfill its mission, the Office of the Medicaid Inspector General (OMIG) performs audits, investigations, and reviews of Medicaid services and providers and works with other federal and state agencies that have regulatory oversight or law enforcement powers. Each year, the agency has identified or recovered billions of dollars in cost avoidance and recoveries to offset Medicaid program costs. OMIG staff primarily work on Medicaid program integrity functions. These positions include auditors, investigators, nurses, data analysts, pharmacists, other clinical/medical professionals, compliance specialists, program administrators/managers, and persons providing legal, technological, and administrative support, in seven offices across the State.
For more information on the NYS Office of the Medicaid Inspector General’s Mission, please visit: https://omig.ny.gov/about-us/about-omig
Duties Include
Minimum Qualifications
GENERAL PUBLIC CANDIDATES: Possession of a bachelor's degree* or higher. No experience is required for appointment as a Trainee 1.
New York State employees with one year of permanent competitive service in a title deemed eligible for transfer under Section 52.6 or 70.1 of the Civil Service Law.
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)
PREFERRED QUALIFICATIONS: Knowledge/experience with computers, specifically with Word and Excel; excellent verbal/written communication; analytical and personal skills; and the ability to work independently as well as with others to resolve conflicts and audit issues.
Additional Comments
FREE PARKING
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.
Specific hours for each position to be discussed at time of interview.
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 $52,198. Salary is non-negotiable.
Benefits of Working for NYS
Generous benefits package, worth 65% of salary, including:
Holiday & Paid Time Off
Duties Description
New York State leads the nation in developing a robust culture of Medicaid program integrity and healthcare compliance. Formed in 2006 to more efficiently use resources dedicated to fighting fraud, waste, and abuse, we are a small agency with a big impact! To fulfill its mission, the Office of the Medicaid Inspector General (OMIG) performs audits, investigations, and reviews of Medicaid services and providers and works with other federal and state agencies that have regulatory oversight or law enforcement powers. Each year, the agency has identified or recovered billions of dollars in cost avoidance and recoveries to offset Medicaid program costs. OMIG staff primarily work on Medicaid program integrity functions. These positions include auditors, investigators, nurses, data analysts, pharmacists, other clinical/medical professionals, compliance specialists, program administrators/managers, and persons providing legal, technological, and administrative support, in seven offices across the State.
For more information on the NYS Office of the Medicaid Inspector General’s Mission, please visit: https://omig.ny.gov/about-us/about-omig
Duties Include
- Conduct audits of managed care organizations that receive cost based rates by performing various tests, reviews, reconciliations, and evaluations of accounts, claims, records and procedures to ensure that reported information is accurate and complete.
- Perform managed care cost report analysis to assist in determining the scope and timeframe to be reviewed.
- Assist in planning audit activities, including specific audit tasks.
- Propose solutions to the supervisor regarding audit issues encountered during the review.
- Prepare work papers and reports to document audit scope, findings and conclusions.
- Communicate professionally and effectively.
- May require travel up to 10%.
Minimum Qualifications
GENERAL PUBLIC CANDIDATES: Possession of a bachelor's degree* or higher. No experience is required for appointment as a Trainee 1.
- Your degree must have been awarded by a college or university accredited by a regional, national, or specialized agency recognized as an accrediting agency by the U.S. Department of Education/U.S. Secretary of Education. If your degree was awarded by an educational institution outside 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.
New York State employees with one year of permanent competitive service in a title deemed eligible for transfer under Section 52.6 or 70.1 of the Civil Service Law.
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)
PREFERRED QUALIFICATIONS: Knowledge/experience with computers, specifically with Word and Excel; excellent verbal/written communication; analytical and personal skills; and the ability to work independently as well as with others to resolve conflicts and audit issues.
Additional Comments
FREE PARKING
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.
Specific hours for each position to be discussed at time of interview.
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 $52,198. 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.
Benefits of Working for NYS
Generous benefits package, worth 65% of salary, including:
Holiday & Paid Time Off
- 13 paid holidays annually
- Up to 13 days of paid vacation leave annually
- Up to 5 days of paid personal leave annually
- Up to 13 days of paid sick leave annually for PEF/CSEA
- Eligible employees and dependents can pick from a variety of affordable health insurance programs.
- Family dental and vision benefits at no additional cost
- New York State Employees’ Retirement System (ERS) Membership
- NYS Deferred Compensation
- Access to NY 529 and NY ABLE College Savings Programs, as well as U.S. Savings Bonds
- Public Service Loan Forgiveness (PSLF)
Salary : $65,001 - $82,656