What are the responsibilities and job description for the Quality Assurance Analyst position at Avani Tech Solutions Private Limited?
Travel will be required up to 50% of the time.
Client Guidance for Subcontracting Partners
- Some overnight stays will be required, sometimes for the entire work week.
- An expense budget will be available for travel costs.
- Expense invoices will be due within 7 days of travel.
- Remote work will be allowed when not traveling.
- Evaluate child/youth’s case for compliance to applicable regulations.
- Clearly communicate evaluation requirements and follow up.
- Evaluate documentation against applicable State/Federal regulations.
- Collect data and documentation to support compliance findings.
- Utilize technology to convert hard copy documentation to electronic and submit via secure file transfer.
- Record, summarize, and communicate compliance findings for the Children’s Transformation Program.
- Assist in determining trends in non-compliance.
- Make appropriate and timely recommendations to project management.
- Assist with the ongoing operationalization of project’s processes and procedures.
- Assist with all internal and external reporting.
- Build and maintain relationships with stakeholders to provide a high level of customer service.
- Travelling to provider sites to perform case reviews.
- Bachelor’s Degree in Public health, healthcare management, psychology, human services, or related field.
- A minimum of 2 years of experience as a Healthcare Compliance Analyst, Auditor, Care Manager, or Medicaid Provider, in a role responsible for conducting oversight, compliance audits or chart reviews, or ensuring quality of care.
- An equivalent combination of advanced education, training, and experience will be considered.
- Experience with Medicaid fee-for-service and/or Managed Care billing.
- Proficiency in MS Excel, MS Word, MS Outlook, MS Visio, MS PowerPoint and MS SharePoint.
- Extensive knowledge of, and experience with, Home and Community-Based Services Waiver programs, including the 1915(c) NYS Children’s Waiver, either as a provider or compliance officer.
- Experience working with eMedNY, CANS-NY, UAS-NY, Medicaid Health Homes, Medicaid Managed Care Organizations (MMCOs), or other related programs/systems.
- Experience with client Medicaid billing, including the use of various Electronic Health Records (EHR) systems.
- Experience working with Office of Mental Health (OMH), Office for People with Developmental Disabilities (OPWDD), or Office of Children and Families (OCFS).
- Experience with compliance audits or chart reviews.
- Ability to work with and relate to staff and demonstrate active listening skills.
- Process oriented and results-driven work strategy.
- Ability to foster teamwork with all levels of management and staff.
- Ability to work well independently and within a team.
- Exceptional customer service relationship techniques, including superior verbal and written communication skills.
- Excellent accuracy and attention to detail.
- Experience in meeting deadlines and adhering to strict standards of performance.
Client Guidance for Subcontracting Partners
- (derived from client and/or contractual requirements, and subject to update as those requirements may change)
- This guidance pertains to laptops that are purchased by our subcontracting partners for their resources (whether employees or contractors) who work on NYSTEC projects.
- Laptops That Are or Will be Managed by the Subcontracting Partner/Firm
- I7 processor
- 8GB RAM (16GB preferred)
- Ethernet Port or Adapter
- Windows 10 Enterprise
- Complex password with at least 14 characters changed annually or in the event of a breach
- Multi-factor authentication wherever available
- Windows Defender Firewall Enabled
- Full disk encryption
- Antivirus
- Enforced Windows Patching
- Standard user account with no administrative rights
- Laptops That Are or Will be Imaged & Managed by ITS
- I7 processor
- 8GB RAM (16GB preferred)
- Ethernet Port or Adapter
- Windows 10 Enterprise (required)
- Dell 5400
- Dell 5410
- Dell 5420
- Dell 5470
