Company: Sentara Healthcare Inc
Location: New York
Posted on: May 16, 2022
This position acts as a Liaison between regulatory agencies and
all internal departments to interpret and apply Medicaid
contractual requirements to work processes. Support quality and
integrity efforts for Government Programs. Assist with the
interpretation of the Virginia Medicaid contract, laws, state, and
federal regulationsThis position involves monitoring, tracking,
trending, and reporting compliance with state, federal, and other
regulatory requirements while managing and reducing compliance
risks. Collaborates with the Manager of Program Administration to
provide support and guidance in response to the changing needs of
the organization, healthcare laws, and governmental policies. The
Clinical Contract Admin will work with his/her manager to
accomplish the following:
- Develop, approve, and implement contractual changes through
work plans, SOPs, policies, and procedures to achieve greater
efficiencies and ensure alignment with regulations.
- Develop and implement monitoring activities based on compliance
requirements in the Medicaid contract and through internal
- Manage the implementation of process changes, DMAS contract
updates or new vendor contracts.
- Analyze reports to monitor program and provider
- Perform audits, reviews, and monitoring to help ensure
processes align with contractual standards and requirements.
- Research regulatory issues and assist in the development of
compliance solutions for new regulations.
- Review data trends for Medicaid reports and capture results to
ensure contractual requirements.
- Develop and monitor controls of corrective action plans (CAPs)
and violations to mitigate risk associated with control
- Identify department breakdown/gaps and provide effective
solutions to operational and technical issues.
- Verify that all policies and procedures are documented
appropriately, implemented, and communicated with the corporate
mission and vision of the organization to ensure best
- Ensure contract requirements are implemented and complied with
contract deliverables and corporate strategy.
- Bachelor's Level Degree
- Managed Care 5 years
- Microsoft Excel
- Microsoft PowerPoint
- Microsoft Word
Keywords: Sentara Healthcare Inc, New York , COMPLIANCE ANALYST, Professions , New York, New York
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