Compliance and Risk Management Specialist

4 days ago

New York, New York, United States FREEDOM CARE , LLC Full time
Compliance and Risk Analyst Job Description

FreedomCare, LLC is seeking a highly skilled Compliance and Risk Analyst to join our team. As a Compliance and Risk Analyst, you will play a critical role in ensuring the company's compliance with regulatory requirements and identifying potential risks to the organization.

Key Responsibilities:
  • Assist in building and maintaining compliance training programs for caregivers in each state where FreedomCare operates.
  • Monitor adherence to training requirements and report to Compliance Managers and General Managers of each state when caregivers are at risk of non-compliance.
  • Be the primary point of contact for audit responses regarding training programs.
  • Report on state-required in-home visits and identify trends to report to Compliance Managers and General Managers of each state when the company is at risk of non-compliance.
  • Be the primary point of contact for audit responses regarding in-home visit percentages.
  • Monitor open complaints and critical incident reports to maintain compliance with closing cases within a timely period.
  • Identify trends and report to Compliance Managers and General Managers of each state if the company is at risk of non-compliance.
  • Conduct physical site visits to audit compliance with policies and guidelines regarding state-required postings.
  • Conduct regular and retrospective audits in new and existing states to ensure consistent adherence to compliance guidelines.
  • Support the Compliance Department in preparing for and managing internal, external, Medicaid, and State audits and inspections.
  • Function as a key liaison in audit readiness and response strategies, improving compliance controls based on audit outcomes.
Requirements:
  • Strong working knowledge of auditing procedures and prior experience applying such guidelines for overall compliance with a large scope, preferably in the healthcare sector.
  • Strong working knowledge of billing and diagnosis codes that would permit proper auditing of reimbursement payments, insurance billing, and claims for a healthcare services/products provider.
  • Minimum of 5 years of experience with progressively increasing responsibility, including coaching employees on guidelines and functions.
  • Prior working experience driving change and new program/system implementation experience.
  • Must possess a compliance mindset with a high level of attention to detail, a proven ability to understand compliance regulations, and an understanding of how those regulations apply to specific situations.
  • Documented ability and success in working cross-functionally to attain/maintain compliance with guidelines and regulations.
  • Background in creating training modules that support a variety of audiences within an organization.
  • Experience driving results in a direct and dotted line reporting environment.
  • Active participation in audit responses with established success rates.
Why Work at FreedomCare?

We are committed to providing a best-in-class employee experience and offer competitive compensation, medical benefits, retirement plans, wellness programs, fun company events, and ongoing learning opportunities to grow your career. We celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based on race, religion, color, national origin, ancestry, age, sex, sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, citizenship or immigration status, or other applicable legally protected characteristics.

Base pay for this role is between $70,000 and $80,000 per year at the commencement of your first year of employment. Compensation decisions are dependent upon a variety of factors, including skill set, years of relevant experience, education, location, and licensure/certifications.

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