What are the responsibilities and job description for the Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 (NY HELPS) position at State of New York - Medicaid Inspector General,...?
The duties that the incumbent of the vacancy will be expected to perform. Duties Description PREFERRED QUALIFICATIONS: Preferred candidates will have strong organizational and time management skills; be able to handle multiple competing priorities; have attention to detail; and excellent written and verbal communication skills. Working knowledge of software systems including eMedNY and FACTS is preferred. A willingness to learn.The Medicaid Integrity Specialist 1 position will support the Division of System Utilization and Review, Bureau of Third Party & Payment Oversight, RAC unit. Duties of the position will include, but may not be limited to: • 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 OSC methodologies.
The minimum qualifications required for this vacancy. 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; 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 regarding the vacancy. 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.**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.
The minimum qualifications required for this vacancy. 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; 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 regarding the vacancy. 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.**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 : $53,764
