Our goal is to solve problems and deliver results for our clients. At Cloud and Things, you can be a part of transforming the public sector’s IT environment. Our team is on the forefront of helping to solve the government's most complex IT challenges. If you are seeking a role that offers the opportunity to work on rewarding projects, consider a career with Cloud and Things.
Overview: We are seeking a Quality Assurance Analyst who will support the NYS DOH Quality Systems Transformation project. In this role you will collaborate with team members to conceptualize, deliver, and support our clients through today’s ever-changing healthcare landscape. Your day-to-day role will be to provide analysis expertise to evaluate the performance of the 1915(c) Children’s 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/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.
Mandatory Skills: - 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.
Desired Skills: - 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 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.
Cloud and Things complies with all applicable federal, state, and local laws regarding recruitment and hiring. All qualified applicants are considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other category protected by applicable federal, state, or local laws. Cloud and Things complies with all applicable federal, state, and local laws regarding recruitment and hiring. All qualified applicants are considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other category protected by applicable federal, state, or local laws.