Medicaid Integrity Specialist 1 (Financial Analysis)/Trainee 1 (FA)/Trainee 2 (FA) (NY HELPS)

GENERAL PUBLIC CANDIDATES: Possession of a bachelor's degree* or higher. No experience is required for appointment as a Trainee 1.
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 accrediting agency by the U.S. Department of Education/U.S. Secretary of Education. If your degree was awarded by an educational institution outside 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.

CURRENT NYS EMPLOYEES:
New York State employees with one year of permanent competitive service in a title deemed eligible for transfer under Section 52.6 or 70.1 of the Civil Service Law.

New York State leads the nation in developing a robust culture of Medicaid program integrity and healthcare compliance. Formed in 2006 to more efficiently use resources dedicated to fighting fraud, waste, and abuse, we are a small agency with a big impact! To fulfill its mission, the Office of the Medicaid Inspector General (OMIG) performs audits, investigations, and reviews of Medicaid services and providers and works with other federal and state agencies that have regulatory oversight or law enforcement powers. Each year, the agency has identified or recovered billions of dollars in cost avoidance and recoveries to offset Medicaid program costs. OMIG staff primarily work on Medicaid program integrity functions. These positions include auditors, investigators, nurses, data analysts, pharmacists, other clinical/medical professionals, compliance specialists, program administrators/managers, and persons providing legal, technological, and administrative support, in seven offices across the State.
For more information on the NYS Office of the Medicaid Inspector General’s Mission, please visit: https://omig.ny.gov/about-us/about-omig

Reporting directly to an audit supervisor, the Medicaid Integrity Specialist 1 (Financial Analysis) duties include:

• Prepare and analyze background information to identify 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.
• Performs 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.
• May participate in the investigation of recipients of various agency program areas and other types of fraud.
• May create, run, review, analyze and maintain ad hoc reports regarding audit data.
• May require travel (field work) up to 75%.

Preferred Skills: Proficiency in the use of Word and Excel; excellent verbal and written communication skills; strong analytical skills; and the ability to work well with others.

Benefits: New York State offers a comprehensive and robust benefits package that includes:

• Multiple Health Insurance Options including prescription coverage.
• No Cost Dental and Vision Care Benefits.
• Life Insurance
• Paid Parental Leave
• Paid Personal Leave, Vacation, Sick Leave, and Holidays
• 13 Paid Holidays
• Up to 13 Days of Sick Leave annually
• Up to 5 days of Personal Leave annually
• Up to 3 days of professional leave annually to participate in professional development
• Health Care Spending Account
• Dependent Care Advantage Account
• Telecommuting (up to 50%) possible through OMIG Telecommuting Program
• Membership in the New York State and Local Employees’ Retirement System
• Voluntary Defined Contribution Plan
• Deferred Compensation Plan 457(b) Plan
• Employee Assistance Program
• Employees may be able to receive loan forgiveness under the Public Service Loan Forgiveness Program (PSLF)
• A commitment to diversity, equity, inclusion and accessibility.

Click here to learn more about New York State Benefits
Why join public service? Joining the public service sector offers a unique opportunity to contribute directly to the well-being of society. Here are some compelling reasons to consider:
1. Public Impact: Make a tangible difference in people’s lives by working on projects and initiatives that address community needs and contribute to the greater good.
2. Sense of Purpose: Public service often comes with a strong sense of purpose, as you play a crucial role in serving the public and promoting the common welfare.
3. Job Stability: Public sector jobs provide stability and security, with competitive benefits, opportunities for professional development, and an active Union presence.
4. Learning and Growth: Public service position involve tackling complex challenges, providing continuous opportunities for learning, growth, and skill development.
5. Collaboration and Teamwork: Work in collaborative environments where teams come together to address societal issues, fostering a sense of camaraderie and shared goals.
6. Ethical Fulfillment: Public sector roles are guided by strong ethical framework.
Consider these aspects when contemplating a career in the public service sector and discover a fulfilling path where your efforts directly impact the well-being of the consumers and communities we serve.
This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS).

No exam required! For the duration of the NY HELPS Program, this title maybe filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply. At this time, agencies may recruit and hire employees by making temporary appointments. In May 2024, if a temporary NY HELPS employee is satisfactorily performing in the position, the appointment will be changed from temporary pending Civil Service Commission Action to permanent non-competitive and the official probationary period will begin.

At a future date (within one year of permanent appointment), it is expected employees hired under NY HELPS will have their non-competitive employment status converted to competitive status, without having to compete in an examination. Employees will then be afforded with all the same rights and privileges of competitive class employees of New York State. While serving permanently in a NY HELPS title, employees may take part in any promotion examination for which they are qualified.