Medicaid Audit Jobs in Rochester, NY (NOW HIRING)

Duties Description Duties include but not limited to: Assist with program development, testing and maintenance. 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. Preferred Experience in the pharmacy industry (e.g., certified pharmacy technician, pharmaceutical distributor/supplier, pharmacy benefit manager, or related setting)

Minimum Qualifications To be considered for appointment through NY HELPS, candidates must meet the open-competitive minimum qualifications for this position. Appointment to the Trainee 1 level requires: 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; OR Associate's degree* AND two years of experience; OR 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 http://www.cs.ny.gov/jobseeker/degrees.cfm

Candidates are responsible for the evaluation fee. Competitive Minimum Qualifications: Current New York State Employee with one year or more of permanent or contingent-permanent competitive service, or 55 b/c service as a Medicaid Integrity Specialist 1; OR current New York State Employee with one year or more of permanent or contingent-permanent service or 55 b/c service in a qualifying title and eligible for transfer under Section 70.1, 70.4, or 52.6 of the Civil Service Law. Preferred Qualifications: 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) NOTE: You will be required to provide proof of education, experience, credential and/or license to demonstrate that you meet the minimum qualifications for appointment

Additional Comments FREE PARKING Permanent, Full-Time, Competitive (for transfer and appointments off a list), Non-Competitive (for appointments through the NY HELPS Program). SALARIES ARE NON-NEGOTIABLE: Trainee 1 salary: $53,764 Trainee 2 salary: $59,994 Grade 18 salary: $66,951 **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. For the duration of the NY HELPS program, this title, may 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.

NOTE ON TELECOMMUTING: OMIG employees may be approved for a maximum of 50% telecommuting, however, they are required to apply and obtain approval through management in accordance with OMIG's Telecommuting Program Guidelines. Some positions may require additional credentials or a background check to verify your identity.