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Healthfirst COE Correspondence Compliance Analyst in Home Office, New York

Description

The Correspondence Center of Excellence (COE) Correspondence Compliance Analyst is responsible for promoting compliance with regulatory requirements to ensure company correspondence fulfills all Centers for Medicare and Medicaid Services (CMS) and State Department of Health (DOH) regulations and meets business needs.

Duties & Responsibilities:

  • Act as department lead; the Analyst is responsible for performing impact analysis, managing and coordinating the implementation of CMS and DOH contract changes, and managing business requests that affect company correspondence.

  • Direct meetings with department lead to review, discuss, and ensure business processes meet regulatory requirements, as well as address any operational impacts and training needs.

  • Creates and/or updates workflows and source documents to ensure changes are in alignment with correspondence content and usage.

  • Manage projects by setting clear project milestones and deliverables as well as communicating goals, objectives and responsibilities; keep the project focused in terms of scope/deliverables and meet project time lines.

  • Work directly with all members of the COE team and other Healthfirst business units as needed to understand correspondence project concepts, objectives, and approach.

  • Perform continuous quality assurance and analysis on legacy correspondence to ensure compliance with CMS and DOH regulations.

  • Manage established correspondence corporate work flow process: Collaborate with marketing, legal and corporate regulatory departments to implement and maintain department correspondence change requests using tracking software.

  • Identify organizational risks and help implement process improvements.

  • Implement, manage and maintain correspondence with assigned delegated vendors.

  • Attend Regulatory, Delegated Vendor meetings and others as deemed appropriate.

  • Additional duties as assigned.

Minimum Qualifications:

  • Bachelor’s degree from an accredited institution or equivalent work experience.

  • Demonstrated Healthcare experience

  • Strong knowledge of CMS and/or New York State DOH regulations.

  • Compliance experience interpreting regulatory requirements within a managed care environment.

  • Working knowledge of internal and external audit process.

  • Intermediate MS Word, Excel, PowerPoint, Adobe Acrobat and corporate email systems required along with basic MS SharePoint and Project.

  • Excellent communication, interpersonal and analytical skills.

  • Strong attention to detail.

Preferred Qualifications:

  • Compliance experience governing medical management and/or appeals and grievances regulatory requirements within a managed care environment.

  • Project management experience within a single department and/or across several departments is preferred.

  • Experience proof reading, writing and editing written communications.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement

REQNUMBER: R005324

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