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249 Glenwood Road
Duties Description PRIMARY DUTIES AND RESPONSIBILITIES:
The Office for People With Developmental Disabilities (OPWDD) provides high-quality, person centered services, supports and advocacy to approximately 130,000+ individuals with developmental disabilities in New York State. We are guided in our interactions with the people we serve and each other by compassion, dignity, diversity, excellence and honesty.
As a condition of Medicaid participation, certain laws require OPWDD as a service provider (state operations) to adopt and implement an effective compliance program to identify areas of Medicaid fraud, waste, and abuse to assist with the integrity of the Medicaid program. The OPWDD State Operations Offices have a responsibility to ensure overall Medicaid compliance within their regions.
The DDPS1 (DDSO Medicaid Liaison) will report to the SOO Director or their designee, and will act as point person with the DDSO Management, and various Central Office Units including the Medicaid Compliance Unit. The incumbents will perform professional, administrative, training, and analytical duties related to district compliance in order to assist with the integrity of the Medicaid program and to mitigate agency revenue losses on claims billed to Medicaid.
• Serve as a local resource and assist in identifying, evaluating and mitigating Medicaid Compliance issues.
• Generally, act as point person with various Central Office Units on billing and claiming issues or audits, allegations of Medicaid fraud, waste, & abuse allegations, or other areas as needed.
• Review claim samples provided by the Office of Audit Services, and corresponding service documentation, for billing compliance quarterly;
• Record results of claim reviews and analyze those results to identify locations and staff where systemic trends of deficient claims indicate additional training needs, proactive measures and/or improved internal controls;
• Evaluate potential or actual non-compliance identified; investigate the frequency, causes, and financial impact and, where warranted, prepare and submit self-disclosure reporting forms;
• Communicate with the SOO Director and DDSO staff on issues within the district including potential fraud or self-disclosures;
• Develop, monitor, record, or facilitate corrective action plans on issues related to compliance;
• Conduct, or assist with, training and education on Medicaid Compliance issues and expectations;
• Participate in statewide meetings and individual meetings with Central Office staff;
• Assist in development of policies and procedures, surveys, reports or forms, as needed;
• Travel to geographic areas within your district; may involve occasional travel to Central Office.
Preferred Knowledge, Skills, or Abilities:
• Microsoft Office Suite skills (Word, Excel, PowerPoint) and Access;
• Analytical and administrative skillsets;
• Presentation and training experience;
• Familiarity with HCBS waiver service programs and Waiver service documentation;
• Familiarity with OPWDD Administrative Memorandums (ADM’s), and regulations;
• Ability to work well independently and in a team environment.
Additional Comments Please note: This Position is pending Division of Budget approval to fill.
• All OPWDD employees must be eligible and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility.
• OPWDD IS AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
• Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at firstname.lastname@example.org.
• Employees on long term leave can bid on positions but must be able to report to work within fourteen (14) days and be able to perform the essential functions of their positions with or without reasonable accommodation (RA). If an employee believes that he or she needs a reasonable accommodation, they should contact the NYS OPWDD Equal Opportunity/Affirmative Central Office at (518) 402-7644 or Email at Affirmative.Action@opwdd.ny.gov to obtain information and RA forms.
• OPWDD participates in Federal Loan Forgiveness Programs. For more information go to: www.studentaid.ed.gov/publicservice.
Some positions may require additional credentials or a background check to verify your identity.
Notes on ApplyingSubmit Response to Posting form, cover letter, and résumé by October 19, 2018 to:
Broome DDSOO Human Resources Office
249 Glenwood Road
Binghamton, NY 13905
Please reference EOA #181019B in all correspondence.