Fund Administration Auditor - Lancesoft : Job Details

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• 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: Division of Medical and Dental Directors

• The Division manages the Bureau of Medical Review, Bureau of Dental Review, and the Medical Indemnity Fund.
• The Medical Indemnity Fund (MIF) was established by Chapter 59 of the 2011 Session Laws of the State of New York.
• The MIF was designed to provide a funding source for future health care costs of qualified plaintiffs, as defined by law, who suffered birth-related neurological injuries due to medical malpractice during a delivery admission.
• Effective October 1, 2019, the New York State Department of Health (DOH) took over the responsibility of overseeing the MIF, previously managed by the Department of Financial Services.
• The Public Consulting Group (PCG) acts as the Fund Administrator handling day-to-day operations, including claims, case management, enrollment, requests for services requiring prior approval, and claims payment.
• Effective July 3, 2024, a new Fund Administrator contract will be executed, with expanded requirements and increased expectations from the existing contract.

Position Description:

• The employee will assist the Office of Health Insurance (OHIP), Division of Medical and Dental Directors, the Medical Indemnity Fund with transitioning the Fund Administrator contracts by serving as the lead project coordinator.

This will include, but is not limited to:

• Coordinating with MIF staff to understand new contract objective, goals, requirements, and expectations for transition
• Develop, maintain and facilitate project timelines, ensuring milestones are achieved on time
• Function as lead point of contact with Fund Administrator project manager and key staff
• ssist with tracking and monitoring contract statuses during transition period
• Report on contract statuses to MIF management and contract leads
• Scheduling and facilitation of contract transition and related meetings

*// Diversity, Equality, and Inclusivity - This means a deep commitment to each other equally, in an open, diversified team environment. We strive to be as diverse as the clients and employees we partner with. We embrace people of any race, ethnicity, national origin, religion, gender identity, and sexual orientation. LanceSoft is a certified Minority Business Enterprise (MBE). //*