Medicaid Integrity Specialist 1 FA/Trainee 1 FA/Trainee 2 FA (NY HELPS)

Duties Include

Duties Description

Reporting directly to an audit supervisor, the Medicaid Integrity Specialist 1 (Financial Analysis) prepares and analyzes background information to identify targets; examines and analyzes fee-for-service and managed care documentation to ensure provider compliance with the rules and regulations of the Medicaid program; prepares work papers, checklists, schedules, narratives, tabular material and analysis of findings; writes memos, letters, exit conference summaries, draft and final audit reports; participates in entrance and exit conferences; communicates with the supervisor, co-workers and provider staff professionally and effectively; adheres to audit deadlines and departments goals; performs a survey of the providers operating procedures to determine the nature, reliability, accuracy and accessibility of records; proposes solutions to the supervisor regarding audit issues encountered during field work; may participate in the investigation of recipients of various agency program areas and other types of fraud; may create, run, review, analyze and maintain ad hoc reports regarding audit data. May require travel (field work) up to 75%.

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.
  
  

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 FA; 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. Position is eligible for additional $4,000 location pay.

• 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.