Auditors

Job Description

Job Description

JOB-20836 Auditors - 25907

Mission statement of OHIP :

The overall mission of the Office of Health Insurance Programs is to optimize the health of Medicaid members by wisely using all available resources. OHIP is responsible for administering New York’s Medicaid budget (approximately $65B for 2018) by collaborating with stakeholders across the health care industry including other state agencies, local and federal government agencies, providers, members, and community-based organizations. OHIP is also responsible for implementation of major initiatives including Medicaid Redesign, the Affordable Care Act, and State Administration of Medicaid.

Division functions :

The Division of Medical and Dental Directors (DMDD) is responsible for supporting and further strengthening the ability to coordinate medical and dental policy direction across all aspects of Medicaid, including managed care, fee-for-service, and waiver programs. The Division also manages the Bureau of Medical Review, Bureau of Dental Review, and the Medical Indemnity Fund.

The Medical Indemnity Fund (MIF) was established for the purpose of reimbursing the health care costs of individuals who have suffered birth-related neurological injuries as a result of medical malpractice. More specifically, the Fund covers the enrollees’ costs of qualified health care services, supplies, equipment, medications, and certain home and vehicle modifications which are deemed necessary by their treating physicians, physician assistants, or nurse practitioners, and are subsequently verified by the Fund. Qualified plaintiffs must be found to have sustained a birth-related neurological injury as a result of medical malpractice by a New York court, and the resulting court-approved settlement or judgment must direct the DOH to enroll the qualified plaintiff in the Fund.

Since October 1, 2019, the Department has served as the overseer of the MIF, per Health and Mental Hygiene Article VII Legislation, Part K.

Position Description :

The employee will assist the Office of Health Insurance (OHIP), Division of Medical and Dental Directors, and the Medical Indemnity Fund with Bureau projects and initiatives serving as the lead project coordinator. This will include, but is not limited to:

• Function as Portfolio Manager for the Bureau, which would include developing project documentation, monitoring progress, establishing timelines, tracking action items to completion, and working with both internal and external stakeholders.
• Manage bureau projects, including the review and revision of Enrollee and Provider Handbooks, updating the Bureau website, creating and/or revising Bureau Forms and assisting with process improvement initiatives.
• Provide support for the MIF Team on additional projects including the Annual Survey, Annual Outstanding Checks Reconciliation, Bureau Reporting, and existing reporting and metrics.
• Assist in drafting and/or reviewing procedures, processes, flowcharts and other documentation for the Bureau. May also require assistance with policy reviews.
• Conducting data review and analysis, identifying trends and patterns and making recommendations for potential data pulls and reports.
• Function as liaison between the Division of Medical and Dental Directors, Office of Regulatory Management and the Bureau.
• Coordinate with MIF staff to understand project objectives, goals, requirements, and expectations.
• Develop, maintain, and facilitate project timelines to ensure milestones are achieved on time and report on project status to MIF management as needed.
• Schedule and facilitate project related meetings which includes developing agendas, capturing minutes and actions items, and coordinating follow-up for future discussions.
• Assist with developing standard operating procedures, form, reporting templates, and procedures based on assigned projects.
• Assist with special projects as assigned.
• All other activities as may be deemed necessary.

Additional Skill Level, Experience or Other Requirements:

The preferred candidate should have the following skills and attributes:

• Project management or coordination experience
• Demonstrated experience creating and facilitating meetings
• Previous experience in governmental project management or contract management preferred but not required
• Proficiency in Microsoft Office Suite, including Word and Excel;
• Experience with Microsoft Project is helpful
• Exceptional organizational skills
• Strong verbal and written communication skills;
• Strong analytical capabilities;
• Ability to be flexible, innovative, and work in a team environment

Established in 2005, Knowledge Builders Inc. (KBI) offers a wide range of services, including Information Technology Consulting, Administrative and Health Care Staffing solutions, Payrolling, and Call Center services to organizations of all sizes, including both private companies and governmental entities. KBI is a certified Woman-Owned Business Enterprise (WBE) recognized by New York State, New York City, and the Port Authority of New York and New Jersey.

Our extensive consultant placements cover a variety of roles, from Technical Architects and Specialists to Developers, Project Managers, Analysts, Executive Secretaries, Nurses, Dietitians, Paralegals, Computer Operators, Food Preparation Workers, and many other occupations. To date, KBI has successfully placed over 1,000 consultants across more than 100 private sector companies and public sector agencies in New York State and throughout the country.

We are dedicated to recruiting candidates who consistently exceed our customers’ expectations.

We provide equal employment opportunity for all applicants and employees regardless of race, color, sex, gender identity, gender expression, religion, age, national origin, citizenship, disability, medical condition, family care status, marital status, domestic partner status, sexual orientation, genetic information, military/veteran status, or any other protected basis.

Company Description

Established in 2005, Knowledge Builders Inc. (KBI) offers a wide range of services, including Information Technology Consulting, Administrative and Health Care Staffing solutions, Payrolling, and Call Center services to organizations of all sizes, including both private companies and governmental entities. KBI is a certified Woman-Owned Business Enterprise (WBE) recognized by New York State, New York City, and the Port Authority of New York and New Jersey.\r\n\r\nOur extensive consultant placements cover a variety of roles, from Technical Architects and Specialists to Developers, Project Managers, Analysts, Executive Secretaries, Nurses, Dietitians, Paralegals, Computer Operators, Food Preparation Workers, and many other occupations. To date, KBI has successfully placed over 1,000 consultants across more than 100 private sector companies and public sector agencies in New York State and throughout the country.\r\n\r\nWe are dedicated to recruiting candidates who consistently exceed our customers’ expectations.\r\n\r\nWe provide equal employment opportunity for all applicants and employees regardless of race, color, sex, gender identity, gender expression, religion, age, national origin, citizenship, disability, medical condition, family care status, marital status, domestic partner status, sexual orientation, genetic information, military/veteran status, or any other protected basis.