Compliance Specialist - Health Plan - Village Care

Join VillageCare as a Full-Time Compliance Specialist and become an integral part of a forward-thinking organization dedicated to excellence in healthcare. This position offers the flexibility of working from home, allowing you to balance your professional and personal life in a way that suits you best. You will have the opportunity to utilize your problem-solving skills while ensuring our compliance standards remain top-notch, directly impacting the quality of care we provide to our members. The role comes with a competitive salary range of $102-$115k, reflecting our commitment to attracting and retaining talented professionals. You'll be working in a high-performance environment with energetic colleagues who value integrity and customer-centricity.

As a team member you'll be able to enjoy benefits such as a generous PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life and Disability, Commuter Benefits, Paid Family Leave, and Additional Employee Discounts. Embrace the chance to advance your career in a dynamic setting where your contributions truly matter!

A little about us

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

Your day as a Compliance Specialist

As a Compliance Specialist at VillageCare, you will play a pivotal role in upholding the integrity of our operations. Reporting directly to the Director of Corporate Compliance, you will oversee daily compliance functions that include conducting thorough file reviews and documenting findings. You will be the vital link between internal departments, ensuring effective resolution of issues while flagging potential systemic concerns for further investigation. Your responsibilities will encompass the independent review and investigation of suspected fraudulent activities, with a focus on collaboration to gather pertinent information.

Moreover, you will assist in developing and monitoring corrective action plans, as well as conducting audits and risk assessments, all while maintaining meticulous documentation. Your clear and concise reports will keep leadership informed on the status of compliance investigations, enabling timely interventions and the establishment of new policies to meet regulatory requirements effectively. Your contributions will drive excellence and uphold the highest standards of compliance within the organization.

Would you be a great Compliance Specialist?

To thrive as a Compliance Specialist at VillageCare, a blend of technical expertise and strong interpersonal skills is essential. Candidates should possess a Bachelor's Degree in Health Care Administration, Public Health, or a related field, complemented by 4-6 years of relevant experience in managed care, compliance, audit, or regulatory affairs. Proficiency in health plan systems and operations is crucial for conducting effective audits and risk assessments.

The ability to independently conduct investigations into suspected fraudulent activities, coupled with strong analytical skills, allows for accurate identification of discrepancies. Clear communication is vital, as you will be responsible for articulating compliance requirements across various levels of staff. Additionally, an eye for detail and organizational skills are necessary for maintaining comprehensive documentation and producing clear response documents.

Our team needs you!

If you have these qualities and meet the basic job requirements, we'd love to have you on our team. Apply now using our online application!

VillageCare is an Equal Opportunity Employer.