StateJobsNY

NY HELPNo

AgencyMedicaid Inspector General, NYS Office of the

TitleInvestigative Specialist 4 Medicaid

Occupational CategoryNo Preference

Salary Grade27

Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)

Salary RangeFrom $103784 to $127830 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Non-competitive Class

Travel Percentage 20%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? Yes

Telecommuting allowed? Yes

County New York

Street Address 90 Church St

14th Floor

City New York

StateNY

Zip Code10007

Minimum Qualifications One year of permanent service as an Investigative Specialist 3 (Medicaid), or two years of permanent service as an Investigative Specialist 2 (Medicaid).

OR

Nine years of experience in conducting field investigations preliminary to administrative actions, civil litigation, or criminal prosecution. This experience must include conducting interviews of witnesses and others; taking written statements and affidavits; collecting and analyzing physical and documentary evidence; preparing detailed written reports of investigative findings; and testifying in court or at formal hearings. Two years of the experience must have been at a supervisory level.

NON-QUALIFYING Investigative Experience includes but may not be limited to: Experience in routine police patrol work, security guard or related security position, tax collector, collector of delinquent accounts, credit checker, legal assistant/attorney, hotel or store detective, loss prevention officer, parole officer, correction officer, guard, inspector, or experience in adoption and/or foster care placement.

Substitutions: an associate degree in criminal justice or related field may substitute for two years of qualifying experience. A bachelor’s degree in criminal justice or a related field may substitute for four years of qualifying experience. Related fields include: law enforcement, police science, criminal justice administration, criminology, criminal investigation, police studies, public justice, forensic accounting, forensic psychology, forensic science, and economic crime management.


PREFERRED QUALIFICATIONS:

Excellent verbal and written communication skills. Proficiency with Microsoft Office Suite with the ability to learn new data systems.

Duties Description The Division of Medicaid Investigations ensures the integrity of the Medicaid program by conducting investigations, recovering over payments, and implementing administrative sanctions against providers. The official workstation of this position will be New York City, however, will have responsibility for supervising staff in regional offices and for oversight of investigative operations that may span statewide.

The incumbent will be responsible for the supervision of investigative units which are tasked to review, detect, and resolve issues of complex fraud or abuse issues. Investigations are accomplished using data mining, review of medical records, interviewing, financial audits and undercover activities, participation in joint investigations with other city, state, and federal agencies.

The incumbent will oversee unit investigations to ensure timely completion of work assignments and ensure all investigation avenues have been used to reach a determination. Testify at administrative and criminal proceedings (including grand juries) as required, administrative actions, civil litigation, or criminal prosecution.


Specific duties of the position include but are not limited to:
• Supervising investigative staff in the downstate regional offices.
• Evaluating complaints of Medicaid fraud, waste, and abuse and assigning complaints for investigation.
• Conducting regular case reviews for all staff to ensure progress meets investigative metrics and appropriate actions are taken.
• Working a personal caseload including complex investigations.
• Drafting correspondence, reports, and notices for public issuance in connection with administrative actions seeking to recoup Medicaid overpayments and impose sanctions.
• Maintaining working relationships with the Special Investigative Units within Managed Care Organizations to discuss fraud trends and matters referred to OMIG.
• Testifying at administrative hearings as necessary.
• Ensuring recoupment of overpayments and/or sanctions where appropriate.
• Completing and reviewing staff performance evaluations.

Additional Comments Non-Competitive, permanent, full-time. There will be minimal mandatory overtime. There is a downstate adjustment of $3,400.

Routine travel is required throughout New York State to supervise staff and conduct fieldwork necessary to complete investigations. Must have a valid driver’s license or otherwise demonstrate the ability to meet the transportation requirements of the position.

Please be aware that because of the nature of the position, an appointment is subject to satisfactory completion of fingerprinting and background check.

Some positions may require additional credentials or a background check to verify your identity.

Name Jennifer Sichak

Telephone

Fax 518-408-0395

Email Address Recruitment@omig.ny.gov

Address

Street 800 North Pearl St

2nd Floor

City Albany

State NY

Zip Code 12204

Notes on ApplyingSubmit resume and writing sample to Jennifer Sichak, Office of the Medicaid Inspector General, 800 North Pearl Street, 2nd floor, Albany, NY 12204, or by email to Recruitment@omig.ny.gov with a subject line Investigative Specialist 4/NYC, or by fax to (518) 408-0395, no later than April 3rd, 2024. It is essential that you describe your training, education, and experience as completely as possible. Ambiguity or vagueness will not be decided in your favor.


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