{"title":"Medicaid Integrity Specialist 1\/Trainee 1
3 weeks ago
Minimum Qualifications This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NYHELPS). As part of NYHELPS, this position requires a bachelor's degree. Appointments will be dependent upon qualification of candidates selected.
Candidates must be reachable on the appropriate eligible list for this title (PCO or PATT), eligible under the 55 b/c program (see below), or eligible to transfer to this title under Section 70.1 or 52.6 of the Civil Service Law.
70.1 Transfer: For a 70.1 transfer to a Medicaid Integrity Specialist 1, SG-18, candidates must have one year of permanent, or contingent-permanent 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 a Medicaid Integrity Specialist 1, SG-18, candidates must have one year or 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 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.
Duties Description These two positions are in the Casualty & Estates Unit (C&E) within the Division of System Utilization and Review (DSUR). Working in this unit includes:
* Assisting with the management of the Third-Party Liability Match and Recovery Contract, specifically the C&E Module within the contract. Under this Module, recovery of Medicaid funds is performed by OMIG's contract vendor relevant to recipient estate assets and personal injury settlements.
* Utilizing various reports including those within the contract vendor's case management system and provided by the contract vendor to sample and analyze contract vendor performance across areas including, but not limited to: customer service, lien and claim filing time frames, lien and claim valuation accuracy, system performance, and reporting accuracy.
* Tracking, escalating, and reconciling any issues found.
* Assisting in the creation and maintenance of policies and procedures that are utilized in monitoring of the C&E Module of the contract.
* Participation in meetings as required.
Additional Comments Familiarity with: SQL, MS Access, Tableau, Computer Science, Data Analytics, Computer language, Computer code, C++, eMedNY, MDW, or Data Mining is a plus.
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