75 New Scotland Avenue
Minimum Qualifications Candidates with the following experience are encouraged to apply:
• 5 plus years of experience with health care compliance programs and requirements
• Knowledge of New York State’s Mandatory Medicaid Compliance Program
• Knowledge of OMH operations
• Knowledge of Medicare, Medicaid requirements
• Prior management experience
• Ability to work independently
• New York State residency will be required at the time of appointment
This position requires visitation to hospitals and/or other health care settings and direct interaction with patients and patient care staff. Upon appointment, the candidate must be fully vaccinated or willing to become fully vaccinated against COVID-19. Candidates who are not fully vaccinated against COVID-19 may not start working until two weeks after their first dose of a COVID-19 vaccine.
Duties Description The Office of Mental Health (OMH) is seeking a qualified candidate for the exempt position of Medicaid Compliance Officer. Under the general direction of the Director of Management and Audit in the Bureau of Audit, the Medicaid Compliance Officer oversees all activities related to the development, implementation, maintenance of and adherence to the Medicaid Compliance Program. The Medicaid Compliance Officer will be responsible for directing employees in regulatory compliance; maintaining an effective compliance program; serving as a primary resource for Medicare/Medicaid reimbursement information; and acting as a consulting resource for reimbursement and regulatory issues. Essential duties and responsibilities of this position include, but are not limited to:
Advising and directing employees in regulatory compliance. This includes the following responsibilities:
• Disseminating information to and educating of 15,000+ employees regarding a broad spectrum of compliance-related topics;
• Maintaining a current working knowledge of Federal and State regulations and policies as they affect OMH through routine review of various resources (e.g., CMS manuals, DMERC manuals, Federal Register notices, applicable government and/or industry related internet information sites, multiple stated Medicaid manuals, State Board of Pharmacy Regulations);
• Functioning as a key OMH representative/liaison in meetings with CMS, Medicare carriers, Medicaid Agencies, other federal/state agencies, and industry organizations regarding regulatory policy;
• Providing education and training about actual, proposed, or pending legislation and regulations that affect operations and identifying operational obstacles to compliance, and working with other employees to identify and implement solutions, and
• Reporting to leadership on compliance-related matters as appropriate.
Maintaining the effectiveness of the Compliance Program. This includes oversight and monitoring of the Compliance Program through:
• Creation/revision of applicable policies and procedures that describe the compliance program expectations;
• Identify areas of risk for the organization and conduct or direct risk assessments;
• Measurement of compliance by conducting routine and/or focused internal reviews or audits of policy/procedure adherence and report findings;
• Formulate plans of corrective action for implementation where vulnerabilities are identified, and monitor progress;
• Communicate to agency management any identified organizational and operational problems and their assessed implication;
• Development, coordination and participation in routine multifaceted educational and training programs that focus on the elements of the Compliance Program thus striving to ensure that all appropriate employees and management are knowledgeable of, and comply with, pertinent Federal and State Health care program requirements; and
• Periodic revision of the Compliance Program in light of changes in the organization's needs, and in the statutes, rules, regulations, and requirements of Federal and State health care programs.
Additional Comments The Bureau of Audit is conveniently located on the grounds of the Capital District Psychiatric Center at 75 New Scotland Avenue, Albany, New York. We offer a comfortable working environment with covered parking available on site for a nominal monthly fee.
Specific scheduled hours and telecommuting availability for this position will be discussed during the interview process. Please note, employees are required to apply and obtain approval through management to telecommute according to operational needs and Agency Telecommuting Program Guidelines.
The Mission of the New York State Office of Mental Health is to promote the mental health of all New Yorkers, with a focus on providing hope and supporting recovery for adults with serious mental illness and children with serious emotional disturbances. Applicants with lived mental health experience are encouraged to apply. The Office of Mental Health embraces diversity and promotes a workplace in which individual differences are recognized, appreciated, and respected. The New York State Office of Mental Health is an equal opportunity/affirmative action employer.
Some positions may require additional credentials or a background check to verify your identity.
44 Holland Avenue
Notes on ApplyingTo be considered for this position, interested candidates should email a cover letter and resume in Microsoft Word or PDF format to email@example.com. Please include the title of the position and Vacancy ID #104948 in the subject line of your email when applying.
You are advised that, should you accept a job offer with the Office of Mental Health, you may be required to be fingerprinted and pay a fingerprint fee.