StateJobsNY

NY HELPNo

AgencyMedicaid Inspector General, NYS Office of the

TitleInvestigative Specialist 1 (2 positions)

Occupational CategoryAdministrative or General Management

Salary Grade18

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

Salary RangeFrom $56604 to $71980 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Non-competitive Class

Travel Percentage 10%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8 AM

To 4 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

County Albany

Street Address 800 North Pearl Street

City Albany

StateNY

Zip Code12204

Minimum Qualifications Six years of experience in a field investigative position conducting interviews of witnesses and others, taking written statements and affidavits, collecting and analyzing physical and documentary evidence, and preparing detailed written reports of investigative findings.

Substitutions: an associate’s 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 and ability to learn new data systems. Ability to analyze and apply data to investigations. Understanding of the services provided to Medicaid recipients through providers within the Home Health Industry. Regular travel, including to areas not served by public transportation, is required. Must have a valid driver’s license or otherwise demonstrate the ability to meet the transportation requirements of the position.

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 incumbent will aid in this endeavor using their expertise to assist in the investigation of providers in potential fraud.

Specific duties of the position include:
• Investigate allegations of Medicaid fraud or abuse;
• Conduct fieldwork, including on-site inspections;
• Operate various data systems; analyze information; and draw appropriate conclusions;
• Obtain sufficient information and documentation to support investigative findings;
• Work complex investigations including drafting correspondence, reports, and notices for public issuance in connection with administrative actions seeking to recoup Medicaid overpayments and impose sanctions;
• Implement cost saving program integrity initiatives;
Testify at administrative hearings as necessary;
• Collaborate with other regulatory oversight agencies and law enforcement and conducting joint investigations as appropriate.
• Consult with regional Division of Medicaid Audit staff concerning potential credible allegations of fraud found during audits;
• Serve as liaison with Managed Care Organizations and participate in regular meetings with their Special Investigation Unit representatives.
• Ensure recoupment of overpayments and/or sanctions where appropriate, and;
• Ensure full compliance with the 180 Day Case Management Process.

Additional Comments Non-Competitive, permanent, and full-time position. There will be minimal mandatory overtime. Filling this position is contingent upon receiving Division of Budget waiver approval.

Routine travel is required in order to 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.
Retirees from public employment will need to specify if they would consider returning to work under Section 212 of the Retirement and Social Security Law. Under Section 212, a retiree may return to public employment, earn up to $35,000, as set by law, and continue to receive his/her retirement benefit.

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

Name Maureen Wilkins

Telephone

Fax 518-408-0395

Email Address maureen.wilkins@omig.ny.gov

Address

Street 800 North Pearl Street

City Albany

State NY

Zip Code 12204

Notes on ApplyingSubmit resume and a writing sample to Maureen Wilkins, Office of the Medicaid Inspector General, 800 North Pearl Street, 2nd floor, Albany, NY 12204, or by email to maureen.wilkins@omig.ny.gov with a subject line Investigative Specialist 1/Albany, or by fax to (518) 408-0395, no later than August 2, 2021. 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.