Program Research Specialist 1/Trainee 1/Trainee 2

Description

Duties Description

• 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 OSSC methodologies.
  
  

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:

For appointment to the Program Research Specialist TRAINEE 1 you must have:

• A bachelor's degree including or supplemented by nine semester credit hours in biostatistics, data analysis, data modeling, economics, econometrics, mathematics, research methods, or statistics.
  
  

For appointment to the Program Research Specialist TRAINEE 2 you must have:

• A bachelor’s degree including or supplemented by nine semester credit hours in statistics, biostatistics, economics, econometrics, mathematics, research methods, data analysis, data science, or data modeling and one year of professional research experience performing the collection, manipulation (e.g., data construction, merging data files, data cleaning, working with data files containing different levels of data) and evaluation of quantitative data directed toward review, analysis, and presentation related to program operations.
  
  

For appointment to the Program Research Specialist 1 you must have:

• A bachelor’s degree including or supplemented by nine semester credit hours in statistics, biostatistics, economics, econometrics, mathematics, research methods, data analysis, data science, or data modeling and two years of professional research experience performing the collection, manipulation (e.g., data construction, merging data files, data cleaning, working with data files containing different levels of data) and evaluation of quantitative data directed toward review, analysis, and presentation related to program operations.
  
  

**A master’s degree or higher including or supplemented by NINE semester credit hours in biostatistics, data analysis, data modeling, economics, econometrics, mathematics, research methods, or statistics may substitute for one year of 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

You must be currently reachable on the appropriate eligible list for this title, eligible under the 55 b/c program, or eligible to transfer to this title under Section 70.1, 52.6, or 70.4 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

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.