Healthcare Compliance Analyst (Remote with travel)

Albany, GA - USA

Monthly Salary: Not Disclosed

Posted on: 17 hours ago

Vacancies: 1 Vacancy

Job Summary

Location: Albany Remote with travel

Travel may be required up to 25% of the time.
- Some overnight stays will be required sometimes for the entire work week.
- An expense budget will be available for travel costs.
  - Expense invoices will be due within 7 days of travel.
Remote work will be allowed when not traveling.

Description

As a Quality Assurance Analyst in the Quality Systems Transformation practice you will collaborate with team members to conceptualize deliver and support our clients through todays ever-changing healthcare landscape. Serving as a Quality Assurance Analyst your day-to-day role as a consultant will be to provide analysis expertise to evaluate the performance of the 1915(c) Childrens Waiver across New York State. This role will be based in our Albany office. This role may include travel across New York State including New York City.

Duties

Evaluate child/youths case for compliance to applicable regulations.
- Clearly communicate evaluation requirements and follow up.
- Evaluate documentation against applicable State/Federal regulations.
- Collect data and documentation to support compliance findings.
- Utilize technology to convert hard copy documentation to electronic and submit via secure file transfer.
- Record summarize and communicate compliance findings for the Childrens Transformation Program.
- Assist in determining trends in non-compliance.
- Make appropriate and timely recommendations to project management.
Assist with the ongoing operationalization of projects processes and procedures.
Assist with all internal and external reporting.
Build and maintain relationships with stakeholders to provide a high level of customer service.
Traveling to provider sites to perform case reviews.

Mandatory Requirements

Experience (6 Years)

Requirements

Bachelors degree in public health healthcare management psychology human services or related field.
A minimum of 2 years of A minimum of 2 years of experience as a Healthcare Compliance Analyst Auditor Care Manager or Medicaid Provider in a role responsible for conducting oversight compliance audits or chart reviews or ensuring quality of care.
An equivalent combination of advanced education training and experience will be considered.
Experience with Medicaid fee-for-service and/or Managed Care billing.
Proficiency in MS Excel MS Word MS Outlook MS Visio MS PowerPoint and MS SharePoint.

Preferred/Desired Qualifications:

Extensive knowledge of and experience with Home and Community-Based Services Waiver programs including the 1915(c) NYS Childrens Waiver either as a provider or compliance officer.
Experience working with eMedNY CANS-NY UAS-NY Medicaid Health Homes Medicaid Managed Care Organizations (MMCOs) or other related programs/systems.
Experience with NYS Medicaid billing including the use of various Electronic Health Records (EHR) systems.
Experience working with Office of Mental Health (OMH) Office for People with Developmental Disabilities (OPWDD) or Office of Children and Families (OCFS).
Experience with compliance audits or chart reviews.
Ability to work with and relate to staff and demonstrate active listening skills.
Process oriented and results-driven work strategy.
Ability to foster teamwork with all levels of management and staff.
Ability to work well independently and within a team.
Exceptional customer service relationship techniques including superior verbal and written communication skills.
Excellent accuracy and attention to detail.
Experience in meeting deadlines and adhering to strict standards of performance.

Location: Albany Remote with travel Travel may be required up to 25% of the time. Some overnight stays will be required sometimes for the entire work week. An expense budget will be available for travel costs. Expense invoices will be due within 7 days of travel. Remote work will ...