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DIG OPERATIONS MANAGER

The Office of Medicaid Inspector General (OMIG) Operations Manager is responsible for supervising a professional and paraprofessional staff and overseeing all human resource functions and Medicaid fraud audit controls for a medium sized state agency. This position is governed by state and federal laws and agency/institution policy.

Class Code:

G250C

Job Grade:

GS11

Special Job Requirements:

None

Typical Functions:

Supervises a medium to large staff by interviewing and hiring, providing training opportunities, scheduling work assignments and evaluating the performance of incumbents, and reviewing and approving administrative actions. Manages agency human resource functions, prepares new employee hire packets, oversees employee payroll processing and fringe benefits, and maintains employee personnel records. Coordinates quality assurance reviews with staff to ensure Medicaid audit procedures are in compliance with state and federal regulations. Identifies internal operating policies and procedures and program impact and advises on audit analyses and recommendations. Initiates corrective actions and revisions and provides technical directions and administrative support to staff and medical providers in relations to audit findings. Participates in the establishment of goals, objectives, and short and long-range planning related to Medicaid fraud investigations and audit controls. Assists agency director in fostering team development and audit productivity. Serves as a contact person to the general public, medical providers, and other state agencies in regard to Medicaid complaints and inquiries. Organizes, arranges, and attends, when necessary, training, conferences, seminars, and meetings. Performs other duties as assigned.

Knowledge, Abilities, and Skills:

Knowledge of state and federal personnel policies, practices, and procedures. Knowledge of state and federal Medicaid fraud procedures. Knowledge of basic health terminology. Knowledge of supervisory practices and techniques. Ability to collect, review, and formulate data into oral and written reports. Ability to determine the accuracy of medical audits and findings. Ability to respond to complaints and inquiries from the public and stakeholders. Ability to implement program recommendations and establish program guidelines.

Minimum Qualifications:

The formal education equivalent of a bachelor’s degree in human resources, social work, public administration, general business, or a related field; plus five years of experience in human resources or social service programs, or a related area, including three years in a supervisory capacity. Additional requirements determined by the agency for recruiting purposes require review and approval by the Office of Personnel Management. OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.

Required Certificates:

None

Exempt:

E
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