Deputy Medicaid Inspector General for Investigations - #263626

Description

Duties Description

Under the general direction of the Medicaid Inspector General, reporting directly to the First Deputy Medicaid Inspector General (First Deputy), the incumbent of this position is a member of the Office of the Medicaid Inspector General (OMIG) executive leadership team, working closely with other Deputies and executive-level staff. The incumbent provides the strategic direction and manages operations of the OMIG’s Division of Medicaid Investigations (DMI), with staff in several regional offices.

Investigations and other supportive functions are a critical component of OMIG’s Medicaid program integrity efforts. DMI seeks to improve provider and recipient behaviors with the goal of protecting the recipient community, while promoting quality care for all within the State’s Medicaid program.

Specific Duties Include, But Are Not Limited To

Provide overall oversight, vision, and direction to the Office of the Medicaid Inspector General’s Division of Medicaid Investigations:

• Confer with the MIG, First Deputy, and/or other executive-level managers to define investigative projects, initiatives, and long-term objectives. Provide guidance to agency executive leadership team regarding DMI functions and objectives.
• Provide expert guidance and input in the proper and consistent application of program regulations as they apply to DMI, including new or emergent areas.
• Oversee the establishment of investigative priorities. Determine or oversee policy, standards, and procedures for all areas of investigative operations.
• Recommend actions to be taken regarding Medicaid fraud, waste, and abuse findings where there are no clear precedents.
• Evaluate coordinated statewide investigative activities and processes for effectiveness and efficiency.
• Monitor progress toward program objectives; evaluate the success of investigative initiatives; develop specific recovery estimates.
  
  

Provide oversight and accountability for the day-to-day operations of DMI:

• Oversee the Assistant MIG; provide a high level of guidance, mentoring, advice, and/or direction in resolving novel, sensitive, critical and high-profile issues.
• Ensure consistency and coordination between Bureaus. Set tone for the Division; communicate directives, priorities, preferences, and approach. Incorporate a culture of inclusiveness and respect.
• Provide vision and direction on Division budget, staffing plans, organizational structure.
  
  

Represent OMIG With Agency Partners And External Stakeholders

• Participate in regular meetings with other Deputies and executive-level staff.
• Form relationships and collaborate on investigations and legal or administrative proceedings with other governmental entities or stakeholders, such as the NYS Attorney General’s Office, the federal Department of Health and Human Services, the federal Office of the Inspector General, local District Attorneys, and other State agencies, relative to joint investigations, best practices, legal and administrative proceedings.
• Represent the OMIG in professional associations or other forums, such as the Medicaid Integrity Institute.
  
  

Preferred Qualifications

Minimum Qualifications

Bachelor’s Degree and/or advanced degree and a minimum of nine years of professional experience in an organized program of fraud investigation. A degree in criminal justice or a health care related field is preferred. At least four years of this experience must have included the management and supervision of subordinate staff. Preferred experience would include an understanding of, and experience with: investigative case management, interactions/procedures relative to law enforcement or prosecutorial entities, surveillance and monitoring, Medicaid program oversight, or other fraud deterrent activities. Excellent oral and written communication skills are also required.

Additional Comments

Full-time, exempt. Salary within the posted range will be commensurate with experience. This is an appointment to a position in the exempt jurisdictional class. All exempt appointments require completion of a background check prior to appointment, and completion of an annual Financial Disclosure Statement. Incumbents serve at the pleasure of the appointing authority, and the employment relationship can be altered at any time by either party.

Free parking is available.