Job Description
Travel will be required up to 50% 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.
Job Duties:
- Evaluate child/youth's 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 Children's Transformation Program.
- Assist in determining trends in non-compliance.
- Make appropriate and timely recommendations to project management.
- Assist with the ongoing operationalization of project's processes and procedures.
- Assist with all internal and external reporting.
- Build and maintain relationships with stakeholders to provide a high level of customer service.
- Travelling to provider sites to perform case reviews.
Required Qualifications:
- Bachelor's Degree in Public health, healthcare management, psychology, human services, or related field.
- 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 Qualifications:
- Extensive knowledge of, and experience with, Home and Community-Based Services Waiver programs, including the 1915(c) NYS Children's 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 client 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.
If you're an effective communicator who enjoys working in complex and collaborative environments, utilizing your critical thinking and research skills to develop solutions for clients, providing support to customers, and have the required education, experience and skills, we want to hear from you.
Client Guidance for Subcontracting Partners
- (derived from client and/or contractual requirements, and subject to update as those requirements may change)
- This guidance pertains to laptops that are purchased by our subcontracting partners for their resources (whether employees or contractors) who work on NYSTEC projects.
- Laptops That Are or Will be Managed by the Subcontracting Partner/Firm
Minimum requirements:
- I7 processor
- 8GB RAM (16GB preferred)
- Ethernet Port or Adapter
- Windows 10 Enterprise
- Complex password with at least 14 characters changed annually or in the event of a breach
- Multi-factor authentication wherever available
- Windows Defender Firewall Enabled
- Full disk encryption
- Antivirus
- Enforced Windows Patching
- Standard user account with no administrative rights
- Laptops That Are or Will be Imaged & Managed by ITS
Minimum requirements:
- I7 processor
- 8GB RAM (16GB preferred)
- Ethernet Port or Adapter
- Windows 10 Enterprise (required)
Client DOH ITS prefers the following models or the newer Dell models:
- Dell 5400
- Dell 5410
- Dell 5420
- Dell 5470
Job Tags
Hourly pay, For contractors, Work from home, Night shift,