Manager, Compliance

Visiting Nurse Service of New York - Manhattan

Posted 792 days ago
  • Experience
    Mid-Senior level
  • Job function
  • Employment type
  • Industry
    Hospital & Health Care
  • Employer job ID
  • Job ID

This is a preview of the Manager, Compliance job at Visiting Nurse Service of New York. To view the full job listing, join LinkedIn - its free!Join LinkedIn - its free!

About this job

Job description

Manages and oversees the VNSNY CHOICE Compliance Program. Performs compliance research and regulatory analysis in order to monitor Medicare/Medicaid statutes and regulations to support business operations. Oversees projects that require significant expertise in insurance and compliance. Assists the Director of Compliance with facilitating accountability and foster a culture of compliance and ethics;ensures quality of care and reduces VNSNY CHOICE risk of Government audits,fines, penalties and sanctions. Ensures all departments maintain the highest level of confidentiality and that all areas meet set guidelines as stipulated in each of the departmental policies and procedures.

Develops, implements, and oversees the company-wide Compliance Awareness, Training, and Education Program, including continuously creating methods for communicating the compliance message throughout the organization and the appropriate and timely training of internal and external parties. Tracks compliance training.

Oversees Risk Management activities by assisting operational areas in the identification of potential areas of compliance vulnerability and risk; develops Risk inventory and updates mitigating activities as needed.

Desired Skills and Experience

Education:  Bachelor’s degree in accounting, human resources, law enforcement, criminal justice, nursing or other healthcare field required. 

Experience:  Minimum 5+ years experience in a supervisory capacity managing a Health Plan Compliance Program in a federally regulated environment, preferably managed care/health care, including interacting with government agencies and regulators for Medicare and Medicaid. Strong knowledge of third-party billing requirements and regulations. Very strong knowledge of Medicare, Medicaid statues, regulations, policies, claim processing, audit and reimbursement principles and procedures related to Health Plan operations required.  Excellent investigative, communication and organizational skills required. Knowledge of HIPAA Privacy and Security Rules and CMS security requirements preferred.  Excellent presentation skills with ability to create and deliver training, informational, and other types of programs. Excellent negotiation and problem-solving skills. Ability to interpret data, regulations and laws, ability to conceptualize, and ability to analyze and disseminate information in a readily understandable manner.

About this company

Visiting Nurse Service of New York

At the Visiting Nurse Service of New York, we are dedicated to providing high-quality health care in the home and the community. We’ve been a vital part of New Yorkers’ lives since 1893, with a tradition of vision and action that has taken our industry in new and important directions. Last year, we served more than 130,000 patients in the five boroughs of New York City, as well as Nassau County and parts of Westchester County. Our patients range from newborns to the oldest of the elderly (90+), and reflect the socio-economic and cultural diversity of the New York metro area. VNSNY’s core services include skilled nursing, rehabilitation therapy, medical social work, nutritional counseling, and personal care services. These services are provided through a variety of programs: Acute/Adult Care Community Mental Health Congregate Care Early Head Start Early Intervention HIV/AIDS Services Home Health Intake Coordination Hospice/Palliative Care Long-Term Home Health Care Program Maternity, Newborn, & Pediatrics Nurse-Family Partnership Program Infusion Care Services Rehabilitation Services VNSNY CHOICE/Managed Long-Term Care Visiting MD Program   VNS CHOICE Community Care is a managed long term care program for frail older adults who wish to remain in their own homes to receive long term care services for as long as possible, but require ongoing assistance due to chronic illnesses and functional decline. The members of the program's highly collaborative care management teams include registered nurses and nurse practitioners, rehabilitation therapists, licensed social workers, and nutritionists. These professionals coordinate and/or provide home-, community- and facility-based long-term care and health-related services. We currently service more than 10,000 members in all five boroughs of New York City.We are seeking talent for the opportunity described below.

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