NY HELPYes

AgencyMedicaid Inspector General, NYS Office of the

TitleMedicaid Integrity Specialist 1/Trainee 1/Trainee 2 Financial Analysis (NY HELPS) - 2 POSITIONS

Occupational CategoryOther Professional Careers

Salary Grade18

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

Salary RangeFrom $66951 to $85138 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Non-competitive Class

Travel Percentage 25%

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 Monroe

Street Address 90 Linden Oaks, Suite 120

City Rochester

StateNY

Zip Code14625

Duties Description 2 POSITIONS:

Duties include but not limited to:
• Prepare and analyze background information to identify audit targets.
• Examine and analyze fee-for-service and managed care documentation to ensure provider compliance with the rules and regulations of the Medicaid program.
• Prepare work papers, checklists, schedules, narratives, tabular material and analysis of findings.
• Write memos, letters, exit conference summaries.
• Draft and finalize audit reports.
• Participate in entrance and exit conferences.
• Communicate with the supervisor, co-workers and provider staff professionally and effectively.
• Adhere to audit deadlines and departmental goals.
• Perform a survey of the providers operating procedures to determine the nature, reliability, accuracy and accessibility of records.
• Propose solutions to the supervisor regarding audit issues encountered during field work.

Position 1:
• Assist in the research, development, and revision of audit protocols to ensure alignment with evolving program requirements and standards.
• Maintain and update centralized tracking systems to monitor the status of numerous protocols as they progress through a multi-phase review process.
• Collaborate with fellow team members to systematically manage and maintain a repository of past discussions, meeting minutes, and internal decisions.
• Partner with Subject Matter Experts (SMEs) to translate audit requirements into user-friendly tools and resources for audit staff.

Position 2
• Experience in the pharmacy industry (e.g., certified pharmacy technician, pharmaceutical distributor/supplier, pharmacy benefit manager, or related setting)

Minimum Qualifications To be considered for appointment through NY HELPS, candidates must meet the open-competitive minimum qualifications for this position.

Appointment to the Trainee 1 level requires:
• Four years of experience performing examinations, analyses, and verifications of financial records of Medicaid providers to determine compliance with program requirements and identify improperly expended Medicaid payments;
OR
• Associate’s degree* AND two years of experience;
OR
• Bachelor’s degree*

** Advanced placement to the Trainee 2 or Grade 18 level may be possible depending on education and experience. It is essential that candidates clearly and concisely indicate exactly how they meet the above minimum qualifications in their resume. Failure to show how you meet the minimum qualifications above may result in disqualifications and removal from consideration.

*Your degree must have been awarded by a college or university accredited by regional, national, or specialized agency recognized as an accredited agency by the U.S. Department of Education/U.S. Secretary of Education. If your degree was awarded by an educational institution outside of 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.

Competitive Minimum Qualifications:

Current New York State Employee with one year or more of permanent or contingent-permanent competitive service, or 55 b/c service as a Medicaid Integrity Specialist 1; OR current New York State Employee with one year or more of permanent or contingent-permanent service or 55 b/c service in a qualifying title and eligible for transfer under Section 70.1, 70.4, or 52.6 of the Civil Service Law.

Preferred Qualifications:
Preferred Skills and Experience:
• Excellent verbal and written communication skills
• Strong analytical, organizational, and critical thinking
• Proficiency in Microsoft Word, Teams, and Excel (including data analysis functions)
• Ability to provide oversight and collaboration within multi-phase process
• High attention to detail and proactive problem-solving skills

Specific to Position 2
• Experience in the pharmacy industry (e.g., certified pharmacy technician, pharmaceutical distributor/supplier, pharmacy benefit manager, or related setting)

NOTE: You will be required to provide proof of education, experience, credential and/or license to demonstrate that you meet the minimum qualifications for appointment.

Additional Comments FREE PARKING

Permanent, Full-Time, Competitive (for transfer and appointments off a list), Non-Competitive (for appointments through the NY HELPS Program).

SALARIES ARE NON-NEGOTIABLE:
Trainee 1 salary: $53,764
Trainee 2 salary: $59,994
Grade 18 salary: $66,951

**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.

For the duration of the NY HELPS program, this title, may be filled via permanent, non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the titles for which they apply.

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.

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

Name Melissa H

Telephone

Fax

Email Address recruitment@omig.ny.gov

Address

Street 800 North Pearl St.

City Albany

State NY

Zip Code 12204

Notes on ApplyingAPPLICATION: Qualified candidates should send a cover letter and resume by email to Recruitment@omig.ny.gov or by fax to (518) 408-0395. You must indicate the VACANCY ID #210416, MIS1FA/Rochester in the subject heading.

PLEASE NOTE: We are unable to open documents from Google Docs, Google Drive, OneDrive, Apple Pages, and/or “the cloud”. Please submit resume as a Microsoft Word or PDF attachment.

OMIG does not participate in E-Verify and does not sponsor visa applications.

The Office of the Medicaid Inspector General is proud to be an equal opportunity employer. We encourage those with unique backgrounds and contributions such as education, culture, ethnicity, race, sex, gender identity and expression, nation of origin, age, languages spoken, veteran’s status, color, religion, disability, sexual orientation, and beliefs to apply.

We provide reasonable and religious accommodations for any part of the application and hiring process. If you have a disability or special need that requires accommodation, please send a request to RARequest@omig.ny.gov. (45300, 45308)