What are the responsibilities and job description for the Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 (NYHELPS) position at New York State Office of the Medicaid Inspector General?
Description
Duties Description
The Bureau of Business Intelligence, Managed Care and Data Platform Unit is recruiting to fill TWO Medicaid Integrity Specialist 1 Trainee positions, which will be tasked with duties related to oversight of the New York State Medicaid Managed Care Plans. These positions require that the employee gain an extensive knowledge of NYS Medicaid claims data, as well as knowledge of NYS encounter data submitted by the plans, and the systems used to submit both to the NYS Medicaid Program. The position is responsible for developing SQL algorithms to find fraud, waste, and abuse in the NYS Medicaid Data Warehouse, and potentially use other large datasets to accomplish this goal. These employees will be trained in SQL so that they may fulfill additional supporting responsibilities which would include data requests received by the Bureau of Business Intelligence.
Qualifications
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:
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
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:
Preferred Qualifications: Proficiency with SQL, MS Access and Excel; Basic understanding of the Medicaid program; Familiarity with large data set.
Additional Comments
FREE PARKING
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.
Duties Description
The Bureau of Business Intelligence, Managed Care and Data Platform Unit is recruiting to fill TWO Medicaid Integrity Specialist 1 Trainee positions, which will be tasked with duties related to oversight of the New York State Medicaid Managed Care Plans. These positions require that the employee gain an extensive knowledge of NYS Medicaid claims data, as well as knowledge of NYS encounter data submitted by the plans, and the systems used to submit both to the NYS Medicaid Program. The position is responsible for developing SQL algorithms to find fraud, waste, and abuse in the NYS Medicaid Data Warehouse, and potentially use other large datasets to accomplish this goal. These employees will be trained in SQL so that they may fulfill additional supporting responsibilities which would include data requests received by the Bureau of Business Intelligence.
Qualifications
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.
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).
- 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.
- 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).
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.
Preferred Qualifications: Proficiency with SQL, MS Access and Excel; Basic understanding of the Medicaid program; Familiarity with large data set.
Additional Comments
FREE PARKING
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.
Salary : $65,001 - $82,656
