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Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Medicaid Program Advisor (Level 2 or 3) - Albany, NY

Division of Eligibility & Marketplace Integration (DEMI)

Bureau of Program Compliance and Audit

50% Onsite 50% Remote

Duties:

The Bureau of Program Compliance and Audit is seeking a highly motivated individual to ensure consumer eligibility and enrollment practices for New York State’s health insurance programs are performed in accordance with applicable State and federal laws, regulations, and policies. The incumbent will participate in self-directed trainings as well as on the job training.

Specific duties and responsibilities for this position may include but are not limited to:

+ Monitoring external audits and reviews, including ones conducted by the Office of State Comptroller (OSC), the Office of the Inspector General (OIG) and the federally mandated Payment Error Rate Measurement (PERM) audit. This typically involves assessing the soundness of the audit methodology, conducting independent examinations of consumer eligibility determinations and payments to ensure findings are truthful and accurate, liaising with appropriate State and federal contacts, and drafting responses to reports, follow-up questions, and requests for additional documentation.

+ Building review protocols, establishing written procedures, designing standardized review worksheets, and developing training components specific to each new internal review project assigned to the bureau. Reviewing completed worksheets by initial and peer reviewers, performing quality control reviews, making preliminary finding determinations, drafting finding reports and preparing executive summaries.

+ Providing technical program integrity assistance to local social service districts and other stakeholders. This includes assisting with root cause analyses, as well as collaborating with program, policy and/or systems staff to correct deficiencies identified during reviews.

+ Overseeing other contract staff and their assignments, setting priorities and deadlines, and evaluating performance.

Providing temporary support to the other bureaus within the group, if needed.

Basic Qualifications:

+ Bachelor's degree

+ 10 years of professional experience

+ 5 years of subject matter expert experience

+ Supervisory experience

Desired Characteristics:

Preferred candidates will have supervisory experience; professional experience in public health insurance programs, including Medicaid, Medicare and/or Child Health Plus. Preferred candidates will also have excellent verbal and written communication skills; strong analytical skills and attention to detail; strong organizational skills; proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team, and to manage multiple priorities in order to meet deadlines; and experience using electronic data systems, such as Medicaid Management Information Systems and health insurance eligibility systems.

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.

Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship including H-1B sponsorship) by SSO. Under the federal laws relating to the F-1 STEM EAD program, SSO may be able to support a STEM EAD extension application at the sole discretion of your Designated School Official. This does not guarantee that any STEM EAD extension application will be approved.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E-Verify participant.

Job Details

Pay Type** **Salary

Education Level** **Bachelor’s Degree

Telecommute Percentage** **50

Hiring Min Rate** **77,000 USD

Hiring Max Rate** **91,000 USD