NY HELP Yes

Agency Medicaid Inspector General, NYS Office of the

Title Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 NY HELPS

Occupational Category Other Professional Careers

Salary Grade 18

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

Salary Range From $65001 to $82656 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Non-competitive Class

Travel Percentage 0%

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 Albany

Street Address 800 North Pearl St

City Albany

State NY

Zip Code 12204

Minimum Qualifications TRAINEE 1 SALARY IS $49,363. THIS SALARY IS NON-NEGOTIABLE. This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS)*To be considered for appointment through NY HELPS, candidates must meet the open-competitive minimum qualifications for this position: • Bachelor’s degree or higher• Advanced placement to the Trainee 2 or Grade 18 level may be possible depending on education and experience. Your degree must have been awarded by a college or university accredited by a 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. 70.1 Transfer: • For a 70.1 transfer to this title, you must have one year of permanent or contingent-permanent competitive service in a 70.1 title allocated to a salary grade 16 or above (11 or above for a Trainee 1, 12 or above for a Trainee 2).70.4 Transfer:• For a 70.4 transfer to this title, your current title must be within two salary grades, and either be on the PCO or be on the PATT and possess a bachelor’s degree. Your score on either the PCO or PATT does not need to be reachable. 52.6 Transfer: • For a 52.6 transfer to this title, you must have one year of permanent or contingent-permanent service in a 52.6 title allocated to a salary grade 16 or above (11 or above for a Trainee 1, 12 or above for a Trainee 2).To determine if your current Civil Service title is eligible for transfer to this title, visit the Career Mobility GOT-IT website: Career Mobility Office » GOT-IT (ny.gov)Appointments via transfer must not result in a second, consecutive transfer with an advancement of more than two S-grades or one M-grade.55-b/c program appointments: For a 55 b/c appointment, you must: • Possess the minimum qualifications for the selected title as established by the Department of Civil Service and listed on the most recent exam announcement. • Meet the applicable minimal mental and/or physical requirements for the job (with a reasonable accommodation if necessary). • Have a current Eligibility Letter from the NYS Department of Civil Service, www.cs.ny.gov/rp55/ and be able to provide it to the Human Resources Office upon request.If you are currently 55 b/c eligible and possess a bachelor’s degree, we encourage you to apply for this position.Depending on qualifications, you may be required to serve a 1 or 2-year traineeship that leads to the full level grade 18 position.

Duties Description PREFERRED QUALIFICATIONS: Previous experience as a Medicaid Integrity Specialist 1, or experience in the Dental industry, or in another healthcare related position. Proficient skills in Microsoft Excel and Word.The Division of Medicaid Investigations (DMI) ensures the integrity of the Medicaid program by conducting investigations, recovering overpayments, implementing administrative sanctions against providers and/or recipients, and can refer for criminal prosecution. The Medicaid Integrity Specialist 1 will function as a member of the Dental Investigations team within the Bureau of Payment Controls & Monitoring in DMI. The incumbent will work as a team member with Dental Service Review Assistant 2, a Public Health Dentist, and an Investigative Specialist 2. This position has field work required.The duties of the position include, but are not limited to: • Conduct data mining of dental provider claims and compile findings and analyses into narrative and statistical reports.• Draft correspondence, referrals to other agencies, and notices of agency actions seeking sanctions and recoveries of overpayments when appropriate.• Respond to provider correspondence and inquiries.• Communicate with providers regarding inquiries of how overpayment amounts were determined, the repayment process, appeal rights, and applicable time frames.• Review documents for quality and consistency, ensuring compliance with applicable laws, rules, or regulations.• Collaborate with Dental Team/Unit staff on investigations.• Testify in administrative hearings as necessary.The field work will include:• Conduct field work including on-site inspections of dental provider offices.• Interview subjects and witnesses, collect, analyze, and secure evidence.

Additional Comments TRAINEE 1 SALARY IS $49,363. THIS SALARY IS NON-NEGOTIABLE. Permanent, Full-Time, Competitive (for transfers and appointments off a list), Non-Competitive (for appointments through the NY HELPS Program). **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. Benefits of Working for NYSGenerous benefits package, worth 65% of salary, including: Holiday & Paid Time Off• 13 paid holidays annually• Up to 13 days of paid vacation leave annually• Up to 5 days of paid personal leave annually • Up to 13 days of paid sick leave annually for PEF/CSEAHealth Care Benefits• Eligible employees and dependents can pick from a variety of affordable health insurance programs.• Family dental and vision benefits at no additional costAdditional Benefits• New York State Employees’ Retirement System (ERS) Membership• NYS Deferred Compensation• Access to NY 529 and NY ABLE College Savings Programs, as well as U.S. Savings Bonds• Public Service Loan Forgiveness (PSLF)

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

Name Jenn 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 Applying Submit resume to Jenn Sichak, Office of the Medicaid Inspector General, 800 North Pearl St, 2nd FL, Albany, NY 12204, OR by email to Recrutiment@omig.ny.gov with a subject line of MIS 1/BPCM, OR by fax to (518) 408-0395, no later than September 15th, 2024.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 Word or PDF attachment.