Medicaid Integrity Specialist

Welcome to the State of New York's job posting for a Medicaid Integrity Specialist! We are seeking an experienced and dedicated individual to join our team in ensuring the integrity and accuracy of the Medicaid program. As a Medicaid Integrity Specialist, you will play a crucial role in preventing fraud, waste, and abuse within the program, ultimately helping to protect the funds of New York taxpayers. If you are passionate about making a difference in the healthcare industry and have a strong background in Medicaid, we encourage you to apply. Join us in our mission to promote integrity and accountability in one of the largest Medicaid programs in the country.

1. Conducting audits and investigations to identify potential fraud, waste, and abuse in the Medicaid program.
2. Reviewing and analyzing data to identify trends and patterns that may indicate fraudulent activity.
3. Collaborating with other departments and agencies to gather information and evidence for investigations.
4. Conducting interviews and site visits to providers and beneficiaries to gather information and evidence.
5. Preparing detailed reports and presenting findings to management and legal teams.
6. Developing and implementing strategies to prevent and detect fraud, waste, and abuse in the Medicaid program.
7. Staying up-to-date on state and federal regulations and laws related to the Medicaid program.
8. Identifying and recommending improvements to policies and procedures to enhance program integrity.
9. Training and educating staff and providers on compliance and fraud prevention.
10. Assisting in the recovery of funds lost due to fraudulent activity.
11. Maintaining accurate and confidential records of investigations and findings.
12. Collaborating with law enforcement agencies and assisting in legal proceedings related to fraudulent activity.
13. Representing the State of New York in meetings and conferences related to Medicaid program integrity.
14. Ensuring compliance with all ethical and professional standards in conducting investigations and handling sensitive information.
15. Contributing to the overall mission of promoting integrity and accountability in the Medicaid program.

According to JobzMall, the average salary range for a Medicaid Integrity Specialist in Albany, NY, USA is between $48,000 and $70,000 per year. This may vary depending on the specific job duties, experience level, and employer.

New York is a state in the northeastern U.S., known for New York City and towering Niagara Falls. NYC’s island of Manhattan is home to the Empire State Building, Times Square and Central Park. The Brooklyn Bridge connects Manhattan with the borough of Brooklyn. The iconic Statue of Liberty stands in New York Harbor. To the east, Long Island has beaches, the Montauk Lighthouse, the ritzy Hamptons and Fire Island.