Compliance Manager

Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members. This true integrative care model addresses psychosocial, housing, behavioral and medical services directly evolving around the needs of each member.

We are a community of individuals from diverse peoples who work together to actively foster a fair, equitable, inclusive environment where all employees receive an invitation to belong. Visit amidacareny.org for more information about the Amida Care culture.

We are actively seeking a highly motivated, innovative and experienced leader to join our team as a Compliance Manager. Compensation will be commensurate with experience.

Position Summary:

The Compliance Manager will work collaboratively with the Senior Director, Compliance/Compliance Officer and the Assistant Director Compliance/Privacy Officer to ensure compliance with all Medicaid regulatory requirements as well as compliance with internal Amida Care policies, where applicable.

Responsibilities:

Review the Monitoring Report and follow up for evidence of Monitoring with appropriate Business Units.
Responsible for oversight of required regulatory reports and follow up for evidence.
Assist with scrubbing and analyzing OMIG audit data and prepare initial draft response.
Responsible for submission and tracking of documents for DOH approval.
Assist with Provider Investigative Report data gathering and input in HCS system.
Coordination of FWA quarterly meetings and other functions as needed.
Responsible for tracking of all distributed Regulatory Requirements and responsible for getting status updates from appropriate business units.
Assist with the preparation of materials for Article 44/49 full operational and targeted surveys.
Assist with research regarding current or pending regulatory requirements as needed.
Assist Sr. Director Compliance/Compliance Officer with Mental Health Parity meeting preparation and follow up on regulatory requirement/items.
Track and monitor needed follow up with Vendor Management staff for any identified vendor compliance issues.
Assist with obtaining information for education and training materials.
Provide assistance with regulatory inquiries from business areas.
Assist with internal audits as needed.
Assist with report preparation for Compliance Committee meetings and BOD meetings.

Amida Care is Diversity, Equity and Inclusion employer committed to full inclusion and elimination of discrimination in all its forms. We strive to develop, promote and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.

EDUCATION REQUIRED

Bachelor’s Degree or equivalent combination of education and relevant work experience

EXPERIENCES AND/OR SKILLS REQUIRED

5 years’ experience in Healthcare Compliance field.
General knowledge of Medicaid Managed Care.
Efficient with MS Word, Excel, PowerPoint, Office.
Exhibit ability to work independently with diligence.
Exhibit a strong commitment to the integrity and effectiveness of the Compliance Department.
Demonstrate ability to work collaboratively and effectively with all areas of the Company.
Demonstrate interpersonal and verbal communication skills.
Demonstrate ability to research facts regarding Compliance issues and incidents.
Demonstrate understanding and sensitivity to multi-cultural values, beliefs and attitudes of both internal and external contacts.
Demonstrate appropriate behavior in line with the Company’s mission, vision and values.

Position Description »