Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 Financial Analysis (NY HELPS) - 2 POSITIONS
- Prepare and analyze background information to identify audit targets.
- Examine and analyze fee-for-service and managed care documentation to ensure provider compliance with the rules and regulations of the Medicaid program.
- Prepare work papers, checklists, schedules, narratives, tabular material and analysis of findings.
- Write memos, letters, exit conference summaries.
- Draft and finalize audit reports.
- Participate in entrance and exit conferences.
- Communicate with the supervisor, co-workers and provider staff professionally and effectively.
- Adhere to audit deadlines and departmental goals.
- Perform a survey of the providers operating procedures to determine the nature, reliability, accuracy and accessibility of records.
- Propose solutions to the supervisor regarding audit issues encountered during field work.
- Assist in the research, development, and revision of audit protocols to ensure alignment with evolving program requirements and standards.
- Maintain and update centralized tracking systems to monitor the status of numerous protocols as they progress through a multi-phase review process.
- Collaborate with fellow team members to systematically manage and maintain a repository of past discussions, meeting minutes, and internal decisions.
- Partner with Subject Matter Experts (SMEs) to translate audit requirements into user-friendly tools and resources for audit staff.
- Experience in the pharmacy industry (e.g., certified pharmacy technician, pharmaceutical distributor/supplier, pharmacy benefit manager, or related setting)
- Four years of experience performing examinations, analyses, and verifications of financial records of Medicaid providers to determine compliance with program requirements and identify improperly expended Medicaid payments;
- Associate’s degree* AND two years of experience;
- Bachelor’s degree*
- Advanced placement to the Trainee 2 or Grade 18 level may be possible depending on education and experience. It is essential that candidates clearly and concisely indicate exactly how they meet the above minimum qualifications in their resume. Failure to show how you meet the minimum qualifications above may result in disqualifications and removal from consideration.
- Your degree must have been awarded by a college or university accredited by regional, national, or specialized agency recognized as an accredited agency by the U.S. Department of Education/U.S. Secretary of Education. If your degree was awarded by an educational institution outside of the United States or its territories, you must provide independent verification of equivalency. This information can be found at Candidates are responsible for the evaluation fee.
- Excellent verbal and written communication skills
- Strong analytical, organizational, and critical thinking
- Proficiency in Microsoft Word, Teams, and Excel (including data analysis functions)
- Ability to provide oversight and collaboration within multi-phase process
- High attention to detail and proactive problem-solving skills
- Experience in the pharmacy industry (e.g., certified pharmacy technician, pharmaceutical distributor/supplier, pharmacy benefit manager, or related setting)
- The Department of Civil Service has developed the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS), which is a streamlined program that allows appointment to this title and others without examination.
Recommended Jobs
Speech-Language Pathologist, Promise Academy
Who We Are: At Harlem Children’s Zone, our mission is to break the cycle of intergenerational poverty and unlock new possibilities for our children, families, and communities. Promise Academy , …
Vessel Traffic Management Specialist
Summary This vacancy is for a GS-2150-11, Vessel Traffic Management Specialist located in the Department of Homeland Security (DHS), United States Coast Guard (USCG), Activities New York, Waterways …
Meat Manager
Position Title: Meat Manager Department: Meat Supervisor: Assistant Branch Manager/Branch Manager FLSA: Non-exempt (Paid by the hour) Position Summary: Responsible for receiving produ…
MSIM Tactical Value, Acquisitions Associate (2027 Program)
Morgan Stanley Investment Management (“MSIM”), together with its investment advisory affiliates, has more than 1,300 investment professionals around the world and $1.8 trillion in assets under manage…
Plant Utilities Engineer 1
NY HELP No Agency State Police, Division of Title Plant Utilities Engineer 1 Occupational Category Skilled Craft, Apprenticeship, Maintenance Salary Grade 14 Bargaining Unit O…
Service Mechanic
Join Henderson Products Inc., located at 22686 Fisher Road, Watertown, NY! We are the North American leader in the design, manufacture and up fit of multi-purpose equipment for heavy-duty work trucks …
US Seasonal Tax-Financial Services Organization-Private Tax- Manager
Location: Anywhere in Country At EY, we’re all in to shape your future with confidence. We’ll help you succeed in a globally connected powerhouse of diverse teams and take your career where…
Assistant Supervisor, Facilities
Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of …
CDL A Driver
Neave Group Outdoor Solutions is the fastest-growing landscape and outdoor solutions firm in the region. We are seeking an experienced CDL A Driver to be responsible for loading and delivering landsc…
Offer: Instructional Support Coordinator, Mathematical Sciences
Instructional Support Coordinator, Mathematical Sciences Who we are Why Rensselaer?Our dynamic global community of changemakers includes some of the world's leading researchers, students, al…