Program Research Specialist 2

This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS).

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 June 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 of 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.
This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). Appointments will be dependent upon qualifications of candidate selected. Candidates eligible for the NY HELPS must meet the open competitive minimum qualifications below:

• A bachelor's degree including or supplemented by nine semester credit hours in biostatistics, data analysis, data modeling, economics, econometrics, mathematics, research methods, or statistics,

AND

• Three years of professional research experience performing the collection, manipulation (e.g., data construction, merging data files, data cleaning, working with data files containing different levels of data) and evaluation of quantitative data directed toward review, analysis, and presentation related to program operations.
  

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, 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).

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.

This candidate will work closely with the RAC manager and other supervisors within the unit. The candidate will coordinate and support the activities of the RAC DAR/FAR project team; as well as the Electronic Visit Verification (EVV). This candidate will review any anticipated project proposals or plans to define basic scope statements and requirements; record and report to Unit Manager on all scheduled RAC recovery work; record and track quality metrics concerning these recoveries as well as the performance of the recovery unit; compile weekly/monthly/quarterly and annual reports for the Bureau; interact with stakeholders such as various OMIG staff units, NYSDOH, RAC Contractor, and coordinate the activities of the project team to ensure that Unit, Bureau, and OMIG Agency objectives are met; Supervise and train OMIG agency staff in RAC recovery project processes and tools used to complete said processes. For this position, a wide range of skill-based knowledge, tools, and specific techniques are required. Expert knowledge of queries/SQL claims knowledge as well as the DAR/FAR process are a required component of this job.
Responsibilities include, but are not limited to:

• Work closely with the RAC contractor on a daily basis and monitor all aspects of the /DAR/FAR process
• Assist in RAC scenario approvals and vetting throughout the agency
• Vet providers and Managed Care Plans, and train staff in this process
• Open FACTS cases and maintain/update throughout the audit process
• Create weekly reports for the RAC contractor for all open projects
• Supervise, train, and oversee RAC DAR/FAR and EVV staff
• Work with the RAC Manager to plan, schedule, monitor workload, and track status of all work assigned and completed within the RAC unit
• Use SQL Developer to verify claim data to be recovered upon within the scope of the RAC projects. Must have an advanced understanding and knowledge of SQL/Query building as well as the eMedNY Thin Client Provider and Claims screens.
• Experience in communicating with contractors, other divisions, and the provider community
• Assist in completing weekly/monthly/quarterly and annual reports for the bureau
• Work closely with OMIG and DOH staff on the EVV. This includes understanding and analyzing EVV data as well as sending out EVV educational letters and possible future audits.
• Assist with special assignments when needed
• Verify and analyze OSC methodologies
• Maintain tracking databases for the RAC unit