Quality Assurance Analyst; Exp w/OMH/OPWDD/OCFS; NYS Medicaid billing; compliance audits; eMedNY
Position: Quality Assurance Analyst (Exp w/OMH/OPWDD/OCFS; NYS Medicaid billing; compliance audits; eMedNY) Overview Employer Industry: Healthcare Compliance Why consider this job opportunity: • Opportunity for career advancement and growth within the organization • Flexible remote work arrangement with occasional travel • Engaging and impactful role in ensuring compliance in healthcare services • Supportive work environment with a focus on collaboration and customer service • Chance to contribute to the Children's Transformation Program and make a meaningful difference in the community What to Expect (Job Responsibilities) • Evaluate cases for compliance with applicable regulations • Communicate evaluation requirements clearly and follow up as necessary • Collect and analyze data to support compliance findings • Summarize and report compliance findings for the Children's Transformation Program • Assist in the operationalization of project processes and procedures while maintaining stakeholder relationships What is Required (Qualifications) • Bachelors degree in public health, healthcare management, psychology, human services, or a related field • Minimum of 2 years of experience as a Healthcare Compliance Analyst, Auditor, Care Manager, or Medicaid Provider • 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 Share Point • Strong attention to detail and accuracy, with exceptional verbal and written communication skills How to Stand Out (Preferred Qualifications) • Knowledge and experience with Home and Community-Based Services Waiver programs, including the 1915(c) NYS Children s Waiver • Familiarity with eMedNY, CANS-NY, UAS-NY, Medicaid Health Homes, or Medicaid Managed Care Organizations • Experience with NYS Medicaid billing and Electronic Health Records (EHR) systems • Background in compliance audits or chart reviews • Strong relationship-building skills and the ability to work collaboratively with diverse teams #Healthcare Compliance #Remote Work #Career Growth #Healthcare Services #Compliance Auditing We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer. #J-18808-Ljbffr Apply tot his job