Minimum Qualifications 1. Must currently be a permanent Developmental Disabilities Program Specialist 1 OR
2. Must be active and reachable on the Civil Service eligible list for Developmental Disabilities Program Specialist 1 OR
3. Eligible for 70.1 transfer by way of current permanent status in a title deemed comparable to Developmental Disabilities Program Specialist 1 by the Department of Civil Service (Must also be within 2 salary grades of the targeted title.
NOTE: Provisional appointments will only be considered if there are insufficient in-title and/or Civil Service list candidates.
Duties Description 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 Medicaid Compliance. The incumbent will be responsible for ensuring quality and compliance by performing professional, administrative, training and analytical duties related to the district's fiscal compliance monitoring and training function to assist with the integrity of the Medicaid program and to mitigate agency revenue losses on claims billed to Medicaid.
This position will cover both Bronx and Manhattan, in addition to traveling to Central Office in Albany, as required.
• Analyzing claims and corresponding service documentation for billing compliance based on claim samples provided by the Office of Audit Services quarterly.
• Recording results of claim reviews and analyze corresponding quarterly reports of deficiencies, transmit reports to SOO Director and Central Office.
• Participating in statewide meetings and individual meetings via telephone and in person, with Central Office staff, as required.
• Communicating with the SOO Director and DDSO staff on issues within the district, such as potential or actual self-disclosures; billing and claiming monitoring and other compliance activities, and submit self-disclosure reporting forms, as necessary.
• Conducting training on issues related to fiscal compliance in the district.
• Identifying additional training needs with Bronx and Manhattan staff and review trends to demonstrate the need for improved internal controls and corrective actions.
• Assisting in the development of policies and procedures.
• Traveling to geographic areas within Bronx and Manhattan, and traveling to Central Office in Albany, as required.
• Working closely with district staff and the SOO Director on identifying physical locations as well as residential staff where systemic trends of deficient claims indicate additional training needs, instituting and facilitating training and improved internal controls.
• Developing, monitoring, recording or facilitating corrective actions on issues related to billing compliance.
• Acting as the DDSO liaison/point person for Metro DDSO (bx and Mn) and the various Central Office Units, including but not limited to, Central Operations, Medicaid Compliance, Office of Audit Services on internal and outside agency audits and on general allegations of Medicaid Fraud, waste and abuse.
• Participating in any Electronic Health Record (EHR) activities, as needed, in order to enhance understanding of the way OPWDD uses Electronic Health Records and Care Coordination systems within State Operations.
Additional Comments Please note:
• If you are employed by state government, you may be able to receive loan forgiveness under the Public Service Loan Forgiveness Program (PSLF). The PSLF Program forgives the remaining balance on Direct Loans after 120 qualifying monthly payments have been made under a qualifying repayment plan while working full-time for a qualifying employer. For more information on PSLF, please visit www.studentAid.gov/publicservice.
• 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 Workforce and Talent Management Central Office (518) 473-9689 or Email at firstname.lastname@example.org to obtain information and RA forms.
• 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 email@example.com.
• For CSEA positions: Local Bidding Agreements will be honored.
• Preference will be given to OPWDD employees impacted by closures. If you are being impacted by closure, please indicate this on your resume/cover letter.
• In order to be eligible for appointment and to maintain employment, you cannot be listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). If you are appointed and subsequently listed as an excluded individual or entity on any of these lists (or excluded from any other Federal or Federally assisted program), you may be terminated from your employment.
• OPWDD is an Equal Opportunity/Affirmative Action Employer
Some positions may require additional credentials or a background check to verify your identity.
Human Resources Office