Permanent Transfer Candidates: Current NYS employee with one year of permanent or contingent-permanent, competitive services as a Health Care Surveyor 3 Nursing, G-22, and be eligible for transfer under Section 70.1 of the Civil Service Law OR Current NYS employee with one year of permanent or contingent-permanent competitive service in a title G-20 or higher meeting the non-competitive minimum qualifications listed below.
Non-Competitive:
License and current NYS registration as a Professional Nurse and three years of post-licensure, specialized professional administrative or professional clinical experience.
Qualifying health facilities and programs include hospitals, nursing homes, adult homes, ambulatory care facilities, managed care organizations, psychiatric centers, diagnostic and treatment clinics, home health agencies, assisted living facilities, hospice, renal dialysis units, alcoholism and substance abuse treatment facilities, developmental centers, and community-based programs for the mentally ill and developmentally disabled.
Experience as an RN in a private doctor’s office or group practice, or as a school nurse is NOT considered qualifying.
Substitution: A bachelor’s degree in nursing may substitute for one year of post-licensure clinical nursing experience; and a master’s degree in nursing may substitute for two years of post-licensure clinical nursing experience.
PREFERRED QUALIFICATIONS:
Bachelor’s degree in Nursing. Experience with Medicaid policy, guidelines, rules, and regulations. Experience with electronic medical records, Microsoft Access. Excellent communication and interpersonal skills. The ideal candidate will also have strong data mining, organizational, and writing skills.
Duties Description The Division of Medicaid Investigations (DMI) ensures the integrity of the Medicaid program by conducting investigations, recovering overpayments, implementing administrative sanctions against providers and/or recipients. The incumbent for this position will work with other individuals in the Recipient Surveillance and Utilization Review System (SURS) Unit within the Recipient Restriction Program within DMI.
• Use professional expertise along with various databases to target Medicaid recipients for miss utilizations of their Medicaid services.
• Use Access programs and query in large claims databases to develop exception criteria against Medicaid data
• Create recipient profile reports to be used by the State Medical Review Team (SMRT)
• Prepare written summary reports of the medical care and services paid for on behalf of the recipient which exhibits aberrations sufficient to restrict the individual
• Refer any information relative to aberrant practices by providers or fraudulent practices by recipients to other units within DMI for further investigation to ensure the enhancement of the integrity of the Medicaid program.
• Working with OMIG program and system staff as necessary.
Additional Comments Permanent, Full Time, Non-Competitive. Free parking available. Minimal travel across New York State. Current licensure and registration to practice as a professional Nurse in New York State is necessary for continued employment as a Health Care Surveyor 3 Nursing. Action will be taken to remove you from your position if you fail to maintain licensure and registration.
*Posted salary range includes statutory hiring rate at Step 4 and job rate for PS&T Grade 22 (77,600 – $98,252) and an additional Geographic Pay Differential of $20,000.
**The Department of Civil Service has developed the Hiring for Emergency Limited Placement Program (HELP), which is a streamlined program that allows appointment to this title and others without examination. This program will be in existence from April 1, 2023, through March 31, 2024.
For the duration of the HELP program, this title will be filled via permanent, non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the titles for which they apply. At the close of the HELP program (March 31, 2024), employees hired under the HELP Program will have their non-competitive employment status converted to competitive status. Employees will then be afforded with all the same rights and privileges of competitive class employees of New York State.
Benefits of Working for NYS
Generous benefits package, worth 65% of salary, including:
Holiday & Paid Time Off
• Thirteen (13) paid holidays annually
• Up to thirteen (13) days of paid vacation leave annually
• Up to five (5) days of paid personal leave annually
• Up to thirteen (13) days of paid sick leave annually for PEF/CSEA
• Up to three (3) days of professional leave annually to participate in professional development
Health Care Benefits
• Eligible employees and dependents can pick from a variety of affordable health insurance programs
• Family dental and vision benefits at no additional cost
Additional Benefits:
• New York State Employees’ Retirement System (ERS) Membership
• NYS Deferred Compensation
• Access to NY 529 and NY ABLE College Savings Programs, as well as U.S. Savings Bonds
• Public Service Loan Forgiveness (PSLF)
• And many more
Some positions may require additional credentials or a background check to verify your identity.
Name Jennifer Sichak
Telephone
Fax 518-408-0395
Email Address Jennifer.Sichak@omig.ny.gov
Address
Street 800 North Pearl St
City Albany
State NY
Zip Code 12204
Notes on Applying Submit resume and cover letter to Jennifer Sichak, Office of the Medicaid Inspector General, 800 North Pearl Street, 2nd floor, Albany, NY, 12204, or by email to Jennifer.Sichak@omig.ny.gov with a subject line of “HCS 3”, or by fax to (518) 408-0395 no later than November 9, 2023.