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Salary- HRA/DEPT OF SOCIAL SERVICES
- Full-Time
- Exam May Be Required
Job Description
The Medicaid Audit and Quality Control’s primary responsibility is to ensure that the eligibility requirements are met and comprehensively documented to avoid potential financial sanctions being levied against the Medicaid Program.
OQI/ MAQC is recruiting for (1) one Administrative Staff Analyst NM to function as a Senior Quality Assurance Analyst, who will:
- Manage and coordinate the preparation of quantitative analysis of the Medical Insurance and Community Services Administration (MICSA) and the Home Care Services Program (HCSP) to provide timely and pertinent data to MAQC director for inclusion in error reports to be forwarded to Medicaid Executives on the key factors causing payment errors. Participate and assist the director in the development of corrective action plans aimed at reducing payment errors to avoid federal and fiscal sanctions.
- Maintain effective quantitative and qualitative standards of work performance, monitoring standards and establishing criteria to improve the performance and productivity of program staff. Develop and revise audit worksheets to ensure uniformity and consistency in program operations. Draft manuals, reference guides and control spreadsheets to be used internally by MAQC audit staff.
- Participate in meetings with MICSA and HCSP program Directors to discuss audit data reported on error reports and corrective action required. Provide data on error trends and shares valuable knowledge in the interpretation of Federal and State quality control regulations and laws.
- Coordinate the preparation of periodic reports through HRA's Enterprise Data Warehouse (EDW) for special projects; formulates narratives for the results and share with MAQC Director to address any discrepancies. Prepare and implement detailed project plans and provides efficient monitoring of the progress of projects to ensure timely completion.
- Conduct EDW queries to determine the population of Medicaid recipients, case types, centers workload, clients' demographics to efficiently obtain parameters for statistically valid audit samples from EDW; convey information and reports related to audit sample methodologies to unit Director.
- Monitor the maintenance of the MAQC audit database to ensure error rates are captured and accurately conveyed in statistical reports; responsible for ensuring audit related documents are stored into the Virtual File Cabinet in accordance with the Office of Quality Assurance policies.
Work Location: 4 WTC
Hours/Schedule: 9AM -5PM
Minimum Qualifications
1. A master's degree from an accredited college in economics, finance, accounting, business or public administration, human resources management, management science, operations research, organizational behavior, industrial psychology, statistics, personnel administration, labor relations, psychology, sociology, human resources development, political science, urban studies or a closely related field, and two years of satisfactory full-time professional experience in one or a combination of the following: working with the budget of a large public or private concern in budget administration, accounting, economic or financial administration, or fiscal or economic research; in management or methods analysis, operations research, organizational research or program evaluation; in personnel or public administration, recruitment, position classification, personnel relations, employee benefits, staff development, employment program planning/administration, labor market research, economic planning, social services program planning/evaluation, or fiscal management; or in a related area. 18 months of this experience must have been in an executive, managerial, administrative or supervisory capacity. Supervision must have included supervising staff performing professional work in the areas described above; or
2. A baccalaureate degree from an accredited college and four years of professional experience in the areas described in "1" above, including the 18 months of executive, managerial, administrative or supervisory experience, as described in "1" above.
Preferred Skills
- Knowledge of Enterprise Data Warehouse (EDW) - Ability to produce reports from EDW. - Excellent written and verbal communication skills. - Strong management and analytical skills. - Proficiency in Microsoft programs such as Word, Excel, and PowerPoint. - Experience with development of customized reports and extracts of data using various platforms. - Eligibility knowledge of the Medicaid program policies and procedures. - Knowledge of the Welfare Management System (WMS) and eMedNY.
55a Program
This position is also open to qualified persons with a disability who are eligible for the 55-a Program. Please indicate at the top of your resume and cover letter that you would like to be considered for the position through the 55-a Program.
Public Service Loan Forgiveness
As a prospective employee of the City of New York, you may be eligible for federal loan forgiveness programs and state repayment assistance programs. For more information, please visit the U.S. Department of Education’s website at https://studentaid.gov/pslf/.
Residency Requirement
New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.
Additional Information
The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.
- Experience Level:Experienced (Non-Manager)
- Category:Constituent Services & Community Programs
