Job Number: 25-05689
Immediate Hire! ECLARO is looking for a
Quality Assurance Analyst for our client in
Albany, NY.
ECLARO's client is working with cutting edge technology to deliver modern user experience for a large scale, complex environment. Come join our team and take the next step in your career!
Responsibilities:
- 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.
- Traveling to provider sites to perform case reviews.
Pay Rate: $51.72-$58.62/Hour
Required Qualifications:
- 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 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 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.
If hired, you will enjoy the following ECLARO Benefits:
- 401k Retirement Savings Plan administered by Merrill Lynch
- Commuter Check Pretax Commuter Benefits
- Eligibility to purchase Medical, Dental & Vision Insurance through ECLARO
If interested, you may contact:
Lester Candilado
jan.candilado@eclaro.com
6466800168
Lester Candilado | LinkedIn
Equal Opportunity Employer: ECLARO values diversity and does not discriminate based on Race, Color, Religion, Sex, Sexual Orientation, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status, in compliance with all applicable laws.
