NY HELPNo

AgencyMedicaid Inspector General, NYS Office of the

TitleMedicaid Integrity Specialist 2

Occupational CategoryNo Preference

Salary Grade23

Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)

Salary RangeFrom $86681 to $109650 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? Yes

Telecommuting allowed? Yes

County Albany

Street Address 800 North Pearl St

City Albany

StateNY

Zip Code12204

Duties Description PREFERRED QUALIFICATIONS:

Excellent computer skills with Microsoft Excel, word and Access and working knowledge of Standard Query Language (SQL), Management Reporting System (MRS), and eMedNY.
Excellent oral and written communication skills in various settings (Formal hearings, legal documents and provider communication).
A clear understanding of the NYS Medicaid Program rules, regulations, and guidelines.



This position will be within The Bureau of Payment Controls & Monitoring (BPCM) in the Division of Medicaid Investigations (DMI). BPCM is a multi-functional team comprised of several Prepayment Claims Review Teams (Medical, Dental and Transportation), a Dental Investigative Team and a Dental Audit Team. This posting is for the Transportation team.
This position is a key leadership position within a busy Transportation team with three primary roles. They will be the Custodian of Cost Savings for the Bureau, supervise transportation staff, and be the lead for transportation recoveries. This position must be comfortable with verifying calculations, public speaking and testifying before an Administrative Law Judge.


Custodian of Cost Savings: The primary duties will be coordinating with the bureau manager to compile and report on Bureau cost savings activity. This includes calculating and confirming data across the teams and verifying the Standard Query Language (SQL) used. These calculations must be verified, and projections calculated for program initiatives. Calculations for future cost savings are reported to executive quarterly.
Specific Responsibilities include:
• Weekly, Monthly, and Annual Division Reporting.
• Verifying queries for accuracy with other divisions.
• Presenting Findings at Agency-wide Workgroup meetings.


Transportation Supervisor: The primary duties will include supervising several staff members and ensuring their work is accurate and timely. This includes administrative duties such as reviewing timesheets and managing time off requests per Bureau needs and mentoring of staff.
• The general responsibilities of the position include, but are not limited to:
• Assisting in targeting and data review.
• Performing review and processing of pended transportation claims, assuring appropriate determinations.
• Performing research and data collection to support actions.
• Assisting in building criteria to capture and process transportation claims.
• Providing official testimony on behalf of New York State during administrative hearings and court proceedings.
• Communicating orally and in writing with Medicaid Providers, OMIG legal staff, independent peers, other agencies, the provider community, and their legal counsel as necessary.
• Supervisory duties
o Mentoring staff
? Ensuring staff are aware of career options
? Expanding staff knowledge in preparation for further career options
o Completing staff training
o Ensuring staff compliance with Agency, division and Bureau policies
o Performance evaluations- both formal annual reviews and daily/weekly task reviews.


Transportation Recoveries: The primary duties will be data mining for billing outliers, analysis of data, drafting the Audit report and communicating with the provider. This process includes hearing rights for the providers so testifying at a hearing regarding this work may be required. Excellent written skills must be utilized to draft the Audit reports as they may need to be defended before an Administrative Law Judge.
Responsibilities include:
• Identifying outliers with data mining tools.
• Analysis/review of data
• Coordinating with Investigations for potential site visits.
• Drafting of Audit Report
o Identifying appropriate New York Codes, Rules and Regulations (NYCRR) applicable to the audit.
o Identifying associated Medicaid Provider manual sub sections
o Preparing and proofreading draft for proper grammar.
• Communication with providers.
• Testifying at hearings

Minimum Qualifications To be eligible for appointment, candidates must be reachable on the OMIG promotional list for Medicaid Integrity Specialist 2, OR be a current New York State employee with one year of permanent or contingent-permanent services in a title deemed eligible for transfer under Section 70.1 or 52.6 of the Civil Service Law.

Additional Comments Permanent, Competitive, full-time. There will be minimal mandatory overtime.

Some positions may require additional credentials or a background check to verify your identity.

Name Jenn Sichak

Telephone

Fax

Email Address Recruitment@omig.ny.gov

Address

Street 800 North Pearl St

2nd Floor

City Albany

State NY

Zip Code 12204

Notes on ApplyingSubmit resume to Jenn Sichak, Office of the Medicaid Inspector General, 800 North Pearl St, 2nd Floor, Albany, NY 12204, OR by email to Recruitment@omig.ny.gov with a subject line of MIS2 BPCM OR by fax to (518) 408-0395, no later than September 30, 2025.

PLEASE NOTE: We are unable to open documents from Google Docs, Google Drive, OneDrive, Apple Pages, and/or “the cloud”. Please submit resume as a Word or PDF attachment.


OMIG does not participate in E-Verify and does not sponsor visa applications.