Job description

Description:At Upward Health, our words speak loudly but our actions speak louder. Our mission is to bring healthcare home to our patients. We serve a high-needs population of people who require extra help with their healthcare – and we bring it to them, wherever they are.
We are growing fast and are looking for an experienced, energetic, dedicated and self-starting Contract and Compliance Administrator in our New York Long Island office. The ideal candidate is expected to provide professional direction, oversight and advice to UH’s Compliance and Quality Improvement Programs, which incorporate all clinical and administrative departments. Serve as the designated Contract and Compliance Administrator for UH and is responsible for implementation of the Compliance Program.
Responsibilities:

• Adhere to regulatory reporting guidelines and filing deadlines through coordination across the organization and ensuring the organization has a clearly defined program for complying with laws and regulations
• Coordinate, review and update existing policies and procedures to adhere to any regulatory requirements for our clients, regulators, vendors, and employees
• Create a system for managing, tracking and reporting status on all client, provider, partner, vendor and government agreements. This would include key milestone and renewal dates.
• Review all deliverables (not just contracts) to CMS or other government agencies for compliance, accuracy and timeliness.
• Ensure alignment with clinical operations on cross-departmental project management in collaboration with the technical teams for any company-wide certification and re-certification
• Lead the alignment of cross-departmental project management of certifications and/or any other regulatory certification needed in current state and in the future
• Review client contracts for alignment with all components of current and future business
• Investigates potential incidents pertaining to healthcare coding, billing and reimbursement, any allegations of fraud, abuse or conflict of Interest, suspected or actual breaches of privacy, confidentiality, and security.
• Develops, performs, supervises and arranges appropriate training and education of all staff, clinicians, and Board members on compliance requirements.
• Act on non-compliance or at-risk situations, creating realistic plans to overcome them
• Lead compliance meetings, organize and own meeting content, minutes, metrics.
• Prepare periodic compliance program reports for BOD input and feedback, execute the Annual Training to the BOD and initiate annual attestations for training completion.
• Oversee of compliance ticket system for questions and issues received including escalation of issues as needed
• Communicates or participates in the development of communications with regulatory agencies regarding investigations and the resolution of any alleged violations.
• Document, collect, and prepare documentation for audits by internal teams, CMS, or other governing bodies

Requirements:

• Bachelor’s Degree required, Master’s in healthcare administration preferred. Candidates with a JD and significant compliance experience are welcome to apply.
• Certification in Health Care Compliance (CHC) preferred.
• Proficiency in the use of Microsoft products and EHR systems, preferably Athena
• Comprehensive subject matter expertise in health care compliance and quality improvement
• Excellent planning, analytic, and problem-solving skills
• Excellent communication (verbal, written, and presentation) skills to convey information to diverse audiences
• Compliance experience with CMS or similar government agencies (Required)
• Experience in training and developing education programs
• Minimum 5-7+ years in a health care compliance or regulatory role, preferably experience in managing government programs
• Effective team leadership and team participation skills board and the public; possesses a consistent and disciplined demeanor and ability to act as a professional role model internally and externally
• Tact and discretion in the conduct of investigations
• Demonstrated knowledge of federal and state laws & regulations and accreditation requirements
• Skilled in quality improvement, systems change, and policy development

Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. All individuals selected for a position will undergo a background check appropriate for the position's responsibilities.
**We require all our employees to be vaccinated and to show proof of vaccination upon hire**
** This is a Remote Role. When doing amazing work with or on behalf of our patients, you will be expected to work from home in a space that is private, professional, and free from distraction. **PM22

Job Type: Full-time

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