Medicaid Integrity Specialist​/Trainee​/Trainee

Duties Description This position is within the Bureau of Casualty & Estate Recovery (BCE), Division of Compliance and Self-Disclosure (DCSD). BCE performs programmatic oversight of New York State’s centralized Casualty & Estate Recovery Program including acting as liaison with various internal and external stakeholders, advising on program related matters, and management of a contract and vendor dedicated to this type of recovery.

Description This position is within the Bureau of Casualty & Estate Recovery (BCE), Division of Compliance and Self-Disclosure (DCSD). BCE performs programmatic oversight of New York State’s centralized Casualty & Estate Recovery Program including acting as liaison with various internal and external stakeholders, advising on program related matters, and management of a contract and vendor dedicated to this type of recovery.

Duties of this position include, but are not limited to:

• Prospectively sample and review cases across all areas and types within the case management database system and provided within reports received to ensure accuracy, timeliness and workflow within C&E recovery efforts.
• Receive and process incoming C&E related inquiries from other OMIG Units, the public, other NYS agencies, and local county Department of Social Services offices.
• Identify and track concerns/questions raised by various stakeholders, their resolution, and impacts to the larger program or existing processes.
• Work collaboratively with team, division management, and agency management to identify program and policy recommendations that further the agency mission and adhere to federal requirements.
• Assist in the creation, updating, and maintenance of the Bureau Manual, and of all protocols and procedures related to Casualty & Estate Recovery.
• Learn and/or seeks training in the software and computer systems used by the Bureau to become proficient in these computer tools.

Preferred Qualifications The preferred candidate will have excellent written and verbal communication, as well as organizational and time management skills. Prior knowledge of OMIG’s casualty (personal injury) and estate recovery program, New York State estate or personal injury law, and/or the New York State Medicaid program, is greatly preferred. Familiarity and skill with research and applying learned information is required.

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

• Two years of experience
  * working with Medicaid Compliance Program data; OR
• Associate’s degree
  * AND one year of experience, OR
• Bachelor’s degree*
• Medicaid programs and services include educating, assisting, and monitoring compliance with program regulations and obligations; developing, clarifying, and ensuring implementation of program requirements; collecting and analyzing data; evaluating and assessing appropriateness of provider or recipient participation in the Medicaid program or the appropriateness of billing or utilization of service; or developing referrals for further action or recommendations for corrective action.
• 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…