Medicaid Integrity Specialist 3
3 days ago
We are seeking a highly skilled Medicaid Integrity Specialist 3 to join our team at the New York State Civil Service. As a key member of our team, you will be responsible for managing two units, the Administrative Remedies Unit and the Enrollment Unit, within the Division of Medicaid Investigations (DMI).
Key Responsibilities- Manage two units, ARU and Enrollment, and currently three direct reports of Medicaid Integrity Specialist 2's.
- Maintain working knowledge of the rules and regulations which impact enrollment and sanctions, including exclusion from Medicaid.
- Coordinate regularly as the primary liaison with the Department of Health, the Justice Center, and the State Education Department as it relates to interdependencies in addressing Medicaid enrollment and sanctions.
- Update, draft, and implement templates, policies, and procedures to support consistent and efficient operations of the units.
- Monitor the workflow of the units to ensure required deadlines and appropriate timelines are met.
- Review the program integrity reviews conducted by staff and ensure appropriate OMIG actions.
- Sign final OMIG determination notices for public issuance.
- Address appeals resulting from OMIG actions which may include participating at Appeals Committee meetings and/or drafting affidavits related to appeals and testifying in court as necessary.
- Ensure timely processing of the units' work to meet strict regulatory defined deadlines.
- Draft and provide routine reports on the units' work including weekly report submissions for review by DMI Management, OMIG Executives, and the Governor's Office, and contribute to OMIG's Annual Report.
- Participate in regular internal and external audits of the units' work including audits by OMIG's Office of Internal Audit and Controls, the Office of the State Comptroller, and the Centers for Medicaid and Medicaid Services (CMS).
- Represent the units on various special projects including but not limited to inter- and intra-agency projects.
To be eligible for appointment, candidates must be reachable on the OMIG promotional list for Management Specialist 3 (Albany) OR be a current New York State employee with one year of permanent or contingent-permanent service in a title eligible for transfer under Section 70.1 or 52.6 of the Civil Service Law.
Some positions may require additional credentials or a background check to verify your identity.
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