Description
Duties Description
The Medicaid Integrity Specialist 1 will join the Managed Care Enrollment and Eligibility Unit at OMIG with an opportunity to start or grow their state career in a collaborative, team-oriented environment. Over the course of a traineeship, the candidate will learn to use databases and software programs available for Medicaid research, including Microsoft Access, eMedNY and the Medicaid Data Warehouse. The selected candidate will support the development of Medicaid managed care audits relating to enrollees residing out-of-state and enrollees who have been retroactively disenrolled from managed care, analyze data, prepare accurate audit reports, oversee mail-out recovery projects, monitor and evaluate responses from providers, and update relevant audit-tracking systems. We are seeking candidates who demonstrate adaptability, a strong work ethic, organizational skills, strong critical thinking skills, attention to detail, excellent interpersonal skills, the ability to work well as a team independently, and eagerness to learn and grow within the role.
Qualifications
Minimum Qualifications
GENERAL PUBLIC: To be considered for appointment through NY HELPS, candidates must meet the open-competitive minimum qualifications for this position.
Appointment To The Trainee 1 Level Requires
- Four years of experience* in the promotion of Medicaid program integrity and appropriate delivery and utilization of Medicaid programs and services; OR
- Associate’s degree* AND two years of experience; OR
- Bachelor’s degree*
- Medicaid programs and services include: educating, assisting, and monitoring compliance with program regulations and obligations; developing, clarifying, and ensuring implementation of program requirements; collecting and analyzing data; evaluating and assessing appropriateness of provider or recipient participation in the Medicaid program or the appropriateness of billing or utilization of service; or developing referrals for further action or recommendations for corrective action.
- Advanced placement to the Trainee 2 or Grade 18 level may be possible depending on education and experience. It is essential that candidates clearly and concisely indicate exactly how they meet the above minimum qualifications in their resume. Failure to show how you meet the minimum qualifications above may result in disqualifications and removal from consideration.
- Your degree must have been awarded by a college or university accredited by 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 NYS EMPLOYEES- 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.
PREFERRED QUALIFICATIONS: The preferred candidate will be proficient with Microsoft Office suite, experience reviewing and verifying documentation, familiarity with the Medicaid program and/or knowledge of/willingness to learn Structured Query Language (SQL).
Additional Comments
Permanent, Full-Time, Competitive (for transfer and appointments off a list)
Non-Competitive (for appointments through the NY HELPS Program).
Salaries Are Non-negotiable
Trainee 1 salary: $53,764
Trainee 2 salary: $59,994
G-18 salary: $66,951
- 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.
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.
