Medicaid Integrity Specialist 3

3 days ago

Albany, New York, United States New York State Civil Service Full time
Job Summary

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.
Requirements

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.

  • Medicaid Integrity Specialist 3

    3 days ago

    Albany, New York, United States StateJobsNY Full time

    Job SummaryThe Medicaid Integrity Specialist 3 will serve as the manager over the Administrative Remedies Unit and the Enrollment Unit within the Division of Medicaid Investigations (DMI). This role requires a strong understanding of Medicaid program rules and regulations, as well as excellent leadership and communication skills.Key ResponsibilitiesManage...

  • Medicaid Support Specialist

    4 weeks ago

    Albany, New York, United States ALTA IT Services Full time

    Medicaid Support Specialist Job DescriptionWe are seeking a highly skilled and detail-oriented Medicaid Support Specialist to join our team at ALTA IT Services. As a Medicaid Support Specialist, you will play a critical role in supporting a fortune 100 company in the federal space.Key Responsibilities:Answer inbound phone calls from Medicaid Providers for...

  • Medicaid Support Specialist

    4 weeks ago

    Albany, New York, United States ALTA IT Services Full time

    Medicaid Support Specialist Job DescriptionWe are seeking a highly skilled and detail-oriented Medicaid Support Specialist to join our team at ALTA IT Services.Key Responsibilities:Takes and processes transactions by telephone, internet, and correspondence from customers and representatives.Enters and maintains database records of customer profiles and...

  • Medicaid Claims Specialist

    2 days ago

    Albany, New York, United States ALTA IT Services Full time

    Medicaid Support Specialist OpportunityWe are seeking a highly skilled and customer-focused Medicaid Support Specialist to join our team at ALTA IT Services.Key Responsibilities:Provide exceptional customer service to Medicaid providers via phone and emailProcess and resolve billing and enrollment issues in a timely and efficient mannerDevelop and maintain...

  • Medicaid Claims Specialist

    15 hours ago

    Albany, New York, United States ALTA IT Services Full time

    Medicaid Support Specialist OpportunityWe are seeking a highly skilled and customer-focused Medicaid Support Specialist to join our team at ALTA IT Services.Key Responsibilities:Takes and processes transactions by telephone, internet, and correspondence from customers and representativesEnters and maintains database records of customer profiles and prepares...

  • Medicaid Program Specialist

    4 weeks ago

    Albany, New York, United States Staffing Solutions Organization LLC Full time

    Job SummaryWe are seeking a highly skilled Medicaid Program Advisor to join our team at Staffing Solutions Organization LLC. As a key member of our team, you will play a critical role in developing and implementing programs that improve the lives of children and families.Key ResponsibilitiesDevelop and maintain knowledge of Medicaid and Medicaid services,...

  • Medicaid Policy Specialist

    3 days ago

    Albany, New York, United States Staffing Solutions Organization LLC Full time

    Job SummaryWe are seeking a highly skilled Medicaid Program Advisor to join our team at Staffing Solutions Organization LLC. As a key member of our organization, you will be responsible for overseeing program policy development, providing technical assistance to regional contractors, and conducting investigations of complaints.Key ResponsibilitiesDevelop and...

  • Medicaid Policy Specialist

    4 weeks ago

    Albany, New York, United States Staffing Solutions Organization LLC Full time

    Medicaid Program Advisor RoleWe are seeking a highly skilled Medicaid Program Advisor to join our team at Staffing Solutions Organization LLC. As a key member of our organization, you will play a critical role in overseeing program policy development, providing technical assistance to regional contractors, and investigating complaints.Key...

  • Medicaid Policy Specialist

    4 weeks ago

    Albany, New York, United States Staffing Solutions Organization LLC Full time

    Medicaid Program Advisor RoleWe are seeking a highly motivated and experienced Medicaid Program Advisor to join our team at Staffing Solutions Organization LLC. As a key member of our team, you will play a critical role in developing, advancing, and evaluating state aging and long-term care policy recommendations.Key Responsibilities:Collaborate with Office...

  • Medicaid Outpatient Finance Director

    3 days ago

    Albany, New York, United States Research Foundation for Mental Hygiene Full time

    Job SummaryWe are seeking a highly skilled Medicaid Outpatient Finance Manager to join our team at the Research Foundation for Mental Hygiene, Inc. This is a full-time position that requires superior analytical and communication skills, with the ability to present information to diverse audiences.Key ResponsibilitiesLead a team of budget and fiscal analysts...

  • Data Integration Specialist

    2 days ago

    Albany, New York, United States TechnoGen Full time

    Job Title: Data Integration SpecialistLocation: Not specifiedDuration: Not specifiedKey Responsibilities: We are seeking a highly skilled Data Integration Specialist to join our team at TechnoGen. The ideal candidate will have extensive experience with relational database management systems, Oracle 10g or higher, and designing and implementing ETL...

  • Medicaid Policy Specialist

    4 weeks ago

    Albany, New York, United States Staffing Solutions Organization LLC Full time

    Job SummaryStaffing Solutions Organization LLC is seeking a highly motivated and experienced Medicaid Program Advisor to join our team. As a key member of our organization, you will play a critical role in developing, advancing, and evaluating state aging and long-term care policy recommendations.Key ResponsibilitiesCollaborate with Office leadership to...

  • Medicaid Policy Specialist

    2 weeks ago

    Albany, New York, United States Staffing Solutions Organization LLC Full time

    Job SummaryWe are seeking a highly motivated and experienced Medicaid Program Advisor to join our team at Staffing Solutions Organization LLC. As a key member of our team, you will play a critical role in developing, advancing, and evaluating state aging and long-term care policy recommendations.Key ResponsibilitiesAssist in the development and...

  • Associate Director, Medicaid Implementation

    3 days ago

    Albany, New York, United States Humana Full time

    Job SummaryWe are seeking an experienced Associate Director to lead our Medicaid Implementation efforts. As a key member of our team, you will be responsible for overseeing the development of solutions to non-standard contractual requirements and local needs of each Medicaid market.Key ResponsibilitiesLead a team of program managers supporting new Medicaid...

  • Data Integration Specialist

    4 days ago

    Albany, New York, United States TechnoGen Full time

    Data Integration Specialist **Job Summary** We are seeking a highly skilled Data Integration Specialist to join our team at TechnoGen. As a key member of our data team, you will be responsible for designing, developing, and maintaining complex data integration solutions using SQL Server SSIS objects. **Key Responsibilities** * Design and develop data...

  • Medicaid Provider Network Relations Specialist

    2 weeks ago

    Albany, New York, United States CVS Corporation Full time

    Job SummaryWe are seeking a skilled Medicaid Provider Network Relations Manager to join our team at CVS Corporation.The successful candidate will be responsible for establishing and maintaining positive relationships with assigned providers and groups, ensuring seamless network relations and partnerships.Key Responsibilities:Develop and implement strategies...

  • Data Integration Specialist

    4 weeks ago

    Albany, New York, United States Apex Ventures Full time

    At Apex Ventures, we welcome individuals of all gender identities to join our team.We're looking for a talented professional to take on new challenges and make a meaningful impact.As a Data Integration Specialist, you'll be part of a strong team working towards a shared goal.The Challenges AheadParticipate in diverse integration projects, analyzing complex...

  • Oracle Data Integrator Specialist

    3 weeks ago

    Albany, New York, United States Software People, Inc. Full time

    Job OverviewWe are seeking a highly skilled Oracle Data Integrator Specialist to join our team at Software People, Inc. The ideal candidate will have extensive experience in designing, building, and testing ETL components and data models for a BIApps Peoplesoft Financials data warehouse.Key Responsibilities:Support and development for the SFS Analytics'...

  • Oracle Data Integrator Specialist

    4 weeks ago

    Albany, New York, United States Software People, Inc. Full time

    Job OverviewWe are seeking a highly skilled Oracle Data Integrator specialist to support and develop the SFS Analytics' Financial Data Warehouse. The ideal candidate will have extensive experience in Oracle technologies, specifically in ETL components and data models for BIApps Peoplesoft Financials data warehouse.Key Responsibilities:Analyze, design, build,...

  • Senior Oracle Data Integrator Specialist

    2 days ago

    Albany, New York, United States Veridic Solutions Full time

    Job Title: ODI DeveloperJob Summary:We are seeking a highly skilled Oracle Data Integrator (ODI) specialist to join our team at Veridic Solutions. The ideal candidate will have extensive experience in designing, developing, and implementing data warehouse ETL solutions using Oracle technologies.Key Responsibilities:* Design and develop ETL processes using...