Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 NY HELPS
- Full Time, onsite
- New York State Office of the Medicaid Inspector General
- New York, United States of America
Salary undisclosed
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Minimum Qualifications
GENERAL PUBLIC CANDIDATES: Possession of a bachelor's degree* or higher. No experience is required for appointment as a Trainee 1.
Advanced placement to the Trainee 2 or Grade 18 level may be possible depending on education and experience.
New York State employees with one year of permanent competitive service in a title deemed eligible for transfer under Section 52.6 or 70.1 of the Civil Service Law.
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)
Preferred Qualifications
Works well as part of a team and independently; and demonstrates strong critical thinking skills, the ability to multitask, attention to detail, and excellent interpersonal skills.
Excellent written and oral communication, grammar and editing skills; critical, independent thinking, and analytical skills; excellent reading comprehension.
Proficiency with Microsoft Office Suite and ability to learn new data systems.
Familiarity with the Medicaid Managed Care/Family Health Plus/HIV Special Needs Plan Contract and other federal and state laws and regulations that govern Managed Care Organizations.
Duties Description
New York State leads the nation in developing a robust culture of Medicaid program integrity and healthcare compliance. Formed in 2006 to more efficiently use resources dedicated to fighting fraud, waste, and abuse, we are a small agency with a big impact! To fulfill its mission, the Office of the Medicaid Inspector General (OMIG) performs audits, investigations, and reviews of Medicaid services and providers and works with other federal and state agencies that have regulatory oversight or law enforcement powers. Each year, the agency has identified or recovered billions of dollars in cost avoidance and recoveries to offset Medicaid program costs. OMIG staff primarily work on Medicaid program integrity functions. These positions include auditors, investigators, nurses, data analysts, pharmacists, other clinical/medical professionals, compliance specialists, program administrators/managers, and persons providing legal, technological, and administrative support, in seven offices across the State.
For more information on the NYS Office of the Medicaid Inspector General’s Mission, please visit: https://omig.ny.gov/about-us/about-omig
Duties Include
Position is eligible for location pay of $3400.
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.
Specific hours for each position to be discussed at time of interview.
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 $52,198. Salary is non-negotiable.
Benefits of Working for NYS
Generous benefits package, worth 65% of salary, including:
Holiday & Paid Time Off
GENERAL PUBLIC CANDIDATES: Possession of a bachelor's degree* or higher. No experience is required for appointment as a Trainee 1.
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 accrediting agency by the U.S. Department of Education/U.S. Secretary of Education. If your degree was awarded by an educational institution outside 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.
New York State employees with one year of permanent competitive service in a title deemed eligible for transfer under Section 52.6 or 70.1 of the Civil Service Law.
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)
Preferred Qualifications
Works well as part of a team and independently; and demonstrates strong critical thinking skills, the ability to multitask, attention to detail, and excellent interpersonal skills.
Excellent written and oral communication, grammar and editing skills; critical, independent thinking, and analytical skills; excellent reading comprehension.
Proficiency with Microsoft Office Suite and ability to learn new data systems.
Familiarity with the Medicaid Managed Care/Family Health Plus/HIV Special Needs Plan Contract and other federal and state laws and regulations that govern Managed Care Organizations.
Duties Description
New York State leads the nation in developing a robust culture of Medicaid program integrity and healthcare compliance. Formed in 2006 to more efficiently use resources dedicated to fighting fraud, waste, and abuse, we are a small agency with a big impact! To fulfill its mission, the Office of the Medicaid Inspector General (OMIG) performs audits, investigations, and reviews of Medicaid services and providers and works with other federal and state agencies that have regulatory oversight or law enforcement powers. Each year, the agency has identified or recovered billions of dollars in cost avoidance and recoveries to offset Medicaid program costs. OMIG staff primarily work on Medicaid program integrity functions. These positions include auditors, investigators, nurses, data analysts, pharmacists, other clinical/medical professionals, compliance specialists, program administrators/managers, and persons providing legal, technological, and administrative support, in seven offices across the State.
For more information on the NYS Office of the Medicaid Inspector General’s Mission, please visit: https://omig.ny.gov/about-us/about-omig
Duties Include
- Conduct compliance program reviews using established procedures and protocols.
- Analyze data and arguments to make well-reasoned determinations for Medicaid managed care reviews.
- Apply Medicaid policy, regulations and Medicaid managed care contracts to reviews.
- Prepare well-written and accurate audit reports using prescribed OMIG agency formats and templates.
- Respond to routine correspondence and inquiries, research or gather additional information as needed.
- Be proficient in using Excel, TeamMate, FACTS, eMedNY and other applications used to obtain information.
- Update relevant audit-tracking systems.
Position is eligible for location pay of $3400.
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.
Specific hours for each position to be discussed at time of interview.
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 $52,198. 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.
Benefits of Working for NYS
Generous benefits package, worth 65% of salary, including:
Holiday & Paid Time Off
- 13 paid holidays annually
- Up to 13 days of paid vacation leave annually
- Up to 5 days of paid personal leave annually
- Up to 13 days of paid sick leave annually for PEF/CSEA
- Eligible employees and dependents can pick from a variety of affordable health insurance programs.
- Family dental and vision benefits at no additional cost
- New York State Employees’ Retirement System (ERS) Membership
- NYS Deferred Compensation
- Access to NY 529 and NY ABLE College Savings Programs, as well as U.S. Savings Bonds
- Public Service Loan Forgiveness (PSLF)
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