NY HELP Yes Agency People With Developmental Disabilities, Office for Title Program Operations Specialist 1 Occupational Category Health Care, Human/Social Services Salary Grade 18 Bargaining Unit PS&T - Professional, Scientific, and Technical (PEF) Salary Range From $65001 to $82656 Annually Employment Type Full-Time Appointment Type Permanent Jurisdictional Class Competitive Class Travel Percentage 0% Workweek Mon-Fri Hours Per Week 37.5 Workday From 9 AM To 5 PM Flextime allowed? No Mandatory overtime? No Compressed workweek allowed? No Telecommuting allowed? Yes County Schenectady Street Address 500 Balltown Road City Schenectady State NY Zip Code 12304 Duties Description OPWDD is required by law to have an effective Medicaid Compliance Program in place. Proactive efforts and resources are needed to mitigate revenue loss and foster improved compliance. The position is necessary to continue progress toward fiscal and programmatic compliance. Duties include but are not limited to the following:- Assist with establishing procedures for the Medicaid Compliance Unit (MCU) as it relates to ensuring Medicaid and Medicare compliance in Article 16 Clinics and for Independent Practitioner Services for Individuals with Developmental Disabilities (IPSIDD). - Research Medicare compliance requirements to develop protocols for reviewing clinical encounters and correcting any errors found during the reviews.- Help to create and review billing reports in the EHR to identify any trends that may indicate incorrect billing. - Ensure incorrect claims are voided and reported as required to oversight entities. - Coordinate with Central Operations to ensure procedure codes, service rates and reimbursement rates in the EHR are correct and updated.- Assist Central Operations in ensuring all clinicians are enrolled in Medicaid and Medicare and meet all licensing and certification requirements. - Work with the DDSO Clinical Directors and Director of State Operated Clinic Operations to ensure services are being properly documented by clinicians and make corrections when possible. - Provide technical assistance related to billing and documenting Article 16 clinical services and IPSIDD services.- Updating and creating user guides and training materials. - Reviewing and updating selected selections of the Medicaid Compliance Program and supporting documents prior to the required annual certification. - Other responsibilities may include monitoring the Medicaid Compliance mailbox and answering questions as they pertain to other service reviews, reviewing Medicaid Compliance Liaison's self-disclosures, quarterly activity summaries, and claim monitoring review to ensure accuracy, and assisting the MCU with other duties as needed. LinkedIn: https://www.linkedin.com/company/nys-office-for-people-with-developmental-disabilities/posts/?feedView=all #LI-EW1 Minimum Qualifications NON-COMPETITIVE MINIMUM QUALIFICATIONS: Program Operations Specialist 1: A bachelor’s degree in a human services field and two years of experience in a federal or state certified human service program. One year of this experience must have been in a professional administrative position in which a major duty involved planning, coordinating, monitoring or evaluating a provision of services for people with developmental disabilities. This experience must have included information gathering and analysis.*A Juris Doctor, master's or higher degree in a related field can substitute for one year of specialized experience. Program Operations Specialist Trainee 2: A bachelor’s degree in a human services field and one year of experience in a federal or state certified human service program, which must have been in a professional administrative position in which a major duty involved planning, coordinating, monitoring or evaluating a provision of services for people with developmental disabilities. This experience must have included information gathering and analysis.*A Juris Doctor, master's or higher degree in a related field can substitute for one year of specialized experience. Program Operations Specialist Trainee 1: A bachelor’s degree in a human services field. COMPETITIVE MINIMUM QUALIFICATIONS: Candidates must be reachable for appointment on the current Civil Service Eligible List or the Professional Career Opportunities (PCO) Eligible List for this title. REASSIGNMENT QUALIFICATIONS: Current Office for People with Developmental Disabilities employees with one year of permanent, contingent permanent, or 55 B/C service as a Program Operations Specialist 1. If you have less than one year, you must be currently reachable on the eligible list. TRANSFER QUALIFICATIONS: Candidates must have one year of permanent competitive or 55-b/c status in the posted title and be eligible for lateral transfer; OR be eligible to transfer via Section 70.1, 70.4, or 52.6 of Civil Service Law. The transfer cannot be a second consecutive transfer resulting in an advancement of more than two salary grades. To determine if your current Civil Service title is eligible for transfer to this title, visit the Career Mobility GOT-IT website https://careermobilityoffice.cs.ny.gov/cmo/gotit/index.cfm.55 B/C QUALIFICATIONS:• Possess the minimum qualifications for this title as established by the Department of Civil Service and listed on the most recent exam announcement. • Meet the applicable minimal mental and/or physical requirements for the job (with a reasonable accommodation, if necessary) • Have a current Eligibility Letter from the NYS Department of Civil Service, www.cs.ny.gov/rp55/, and be able to provide it to the Human Resources Office upon request. Preferred Qualifications: Experience with medical billing and coding and knowledge of Medicare and Medicaid The position may be filled at the Program Operations Specialist Trainee 1 level equated to SG-14, ($52,198), Program Operations Specialist Trainee 2 level equated to SG-16 ($58,247) or full performance Program Operations Specialist 1 SG-18 ($65,001), based on education and experience. Candidates hired at the trainee level will be advanced to the full performance Program Operations Specialist 1 SG-18 following the successful completion of the traineeship. Additional Comments • NY HELPSThis title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). HELPS Program titles may be filled via a noncompetitiveappointment. This means that you do not need to take an exam to qualify, but you do need to meet the minimum qualifications of the title.At a future date (within one year of permanent appointment), employees hired under NY HELPS are expected to have their permanent non-competitiveemployment status converted to permanent competitive status. You will not have to take an exam to gain permanent competitive status.• If you are currently a New York State employee serving in a permanent competitive qualifying title and eligible for a transfer via Section 70.1 of the Civil Service Law, you may be appointed to this title as a permanent competitive employee• Preference will be given to OPWDD employees impacted by closures. If you are being impacted by closure, please indicate this on your resume/cover letter.• All OPWDD employees must be eligible and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continuedemployment will depend on maintaining eligibility.• All OPWDD employees must be eligible and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continuedemployment will depend on maintaining eligibility.• If you are employed by state government you may be able to receive loan forgiveness under the Public Service Loan Forgiveness Program (PSLF). The PSLF Program forgives the remaining balance on Direct Loans after 120 qualifying monthly payments have been made under a qualifying repayment plan whileworking full-time for a qualifying employer. For more information on PSLF, please visit www.studentAid.gov/publicservice• Employees on long term leave can bid on positions but must be able to report to work within fourteen (14) days and be able to perform the essential functionsof their positions with or without reasonable accommodation (RA). If an employee believes that they need a reasonable accommodation, they should contactthe NYS OPWDD Workforce and Talent Management Central Office at (518) 473-4785 or Email at accommodationrequests@opwdd.ny.gov to obtaininformation and RA forms.• The Office for People With Developmental Disabilities (OPWDD) and its Division of State Operations is committed to creating and sustaining a culture of inclusion. We believe that we are most effective in managing and improving our service system with a diverse team of employees. With such a large workforce, we rely on the collective individual differences, life experiences, knowledge, self-expression, ideasand talent that our employees bring to their work. This speaks to our culture, and is a key part of our successes. As we continuously recruit people for ourteam, we welcome the unique contributions that applicants bring in terms of their education, culture, ethnicity, race, sex, gender identity and expression, nationof origin, age, languages spoken, veteran’s status, color, religion, disability, sexual orientation and beliefs.• If an employee or job applicant believes that they need a reasonable accommodation, they should contact the Reasonable Accommodation Unit at (518)486-7222 or email accommodationrequests@opwdd.ny.gov to obtain information and RA forms. Some positions may require additional credentials or a background check to verify your identity. Name Emilee Walker Telephone 518-473-4785 Fax 518-474-9902 Email Address MainOffice.Careers@opwdd.ny.gov Address Street 44 Holland Ave City Albany State NY Zip Code 12229 Notes on Applying Please submit a cover letter and resume as an attached PDF or Word document by March 13, 2025. Please reference the EOA# 2025-046 in all correspondence