Avp - Medicare Compliance Operations

Assistant Vice President - Medicare Compliance Operations

VillageCare of New York

120 Broadway, New York, NY 10271

VillageCare is seeking an experienced and enthusiastic AVP of Medicare Compliance Operations to join our Compliance, Audit & Regulatory team. The AVP will support daily compliance activities for the Medicare product line through leadership, focus on systems, reporting and monitoring, program audit readiness, and cross-functional issues that impact Medicare risk. Acting as a primary subject matter expert and keeping current with various levels of legislation on health care, Medicare, and health plan policy will be crucial to this position.

Some essential job functions of this role will include:

• Manage Medicare compliance activity related to CMS program audit readiness, systems, reporting, and related monitoring.
• Lead cross-functional initiatives and projects, including FDRs.
• Oversee regulatory reporting for the Medicare Advantage D-SNP, Fully Integrated Dual Eligible (FIDE} SNP and other Medicare products as necessary.
• Develop collaborative solutions and policies that support prudent compliance with state & federal regulatory requirements.
• Drive remediation, participate in agency/mock audits, and audit and validate CMS Universes.
• Maintain a comprehensive and current understanding of the Medicare managed care industry including proposed and enacted regulations, competitive landscape, risks, and trends.
• Cultivate/maintain effective, strong, and cooperative working relationships with federal and state government relations contacts as well as internal stakeholders and business operational areas.

We would like to speak with those who have a Bachelor's degree in Public Administration, Public Policy, Business Management or related field. Master's degree highly preferred. 5-7 years of experience within managed care required, with at least 3+ years of direct experience in Medicare compliance and development of program audit universes.

There are many benefits to working for VillageCare. If you are someone who likes being part of a team, enjoys a highly competitive benefits package from world leading carriers and competitive compensation, than we would love to speak with you!

• PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life & Disability, Commuter Benefits, Paid Family Leave, Additional Employee Discounts

VillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible. We are committed to superior outcomes in quality health care.

VillageCare is an Equal Opportunity Employer.