What are the responsibilities and job description for the Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 position at State of New York - Medicaid Inspector General, NYS Office of the?
Preferred candidates will have excellent verbal and written communication skills; strong analytical skills and attention to detail, strong organizational skills; the ability to work as part of a team; proficiency in Microsoft Office Programs, specifically Word, Excel, and Outlook; ability to analyze claims data.
Duties include but are not limited to:
- Intake of Medicaid fraud allegations
- Utilize Medicaid data systems in support of allegation intake
- Create cases in the internal tracking system (FACTS)
- Prepare case files for triage by investigations
- Work collaboratively with unit staff and management
- Communicate professionally with the public, other agencies, and other divisions within OMIG.
- Assist with special projects as needed.
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.
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.
Additional Comments Permanent, Full-Time, Competitive (for transfer and appointments off of a list), Non-Competitive (for appointments through the NY HELPS Program).
Trainee 1 salary: $56,183
Trainee 2 salary: $62,694
G-18 salary: $69,964
SALARIES ARE 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.
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.
Some positions may require additional credentials or a background check to verify your identity.
Salary : $56,183 - $88,970