HealthLink Compliance Director, HealthLink Health Home

Job Description

Job Description

Who We Are: CAMBA is a community of staff, volunteers, clients, donors, neighbors and partners who work together to build an inclusive New York City, where all children and adults have access to the resources and supports they need to thrive. We take a comprehensive approach by offering more than 180 integrated programs in: Education & Youth Development, Family Support, Job Training & Employment Support Services, Health, Housing, and Legal Services. We reach more than 73,000 individuals and families, including almost 13,000 youth. CAMBA serves a diverse cross section of New Yorkers from new mothers in Brownsville to job seekers in the Rockaways. More than half of our clients are immigrants and refugees from around the globe. Over 85% of our families are in living in poverty, reflecting the challenges faced by nearly 1.7 million New Yorkers today.

CAMBA’s HealthLink program is a care management program, committed to improving health outcomes for individuals with HIV/AIDS, serious mental illness, or two or more chronic health conditions, through coordinated networks of medical, psychiatric, behavioral health, social service and housing providers. Funded by Medicaid and pursuant to contracts with two New York State Health Homes, Brooklyn Health Home and Skyward Health, HealthLink program staff function as a care management agency, providing clients with personal care coordinators.

Position: HealthLink Compliance Director

Reports To: Chief Legal Officer

Location: 2244 Church Avenue, Brooklyn NY 11226

What Does the HealthLink Compliance Director Do:

• Oversee and monitor the adoption, implementation and maintenance of the HealthLink Compliance Program, and at least annually, evaluate its effectiveness in a written report.
• Draft, implement and update the HealthLink Compliance Plan no less frequently than annually, or as otherwise necessary, to conform to changes in Federal and State laws rules, regulations, policies and standards.
• Review and revise the other written policies, procedures and standards of conduct comprising the HealthLink Compliance Program.
• Report directly on a regular basis but no less frequently than quarterly to CAMBA’s board-level Compliance Committee, including to CAMBA’s CEO/President and the Board Member Compliance Committee Chair.
• Assist in establishing methods to improve the HealthLink program’s efficiency and quality of services, and reduce vulnerability to fraud, waste and abuse.
• Investigate and take action on matters related to the HealthLink Compliance Program, independent of any program interest in protecting its billing outcomes, including designing and coordinating internal investigations, and documenting, reporting, coordinating and pursuing any resulting correction action.
• Assess the support provided by existing HealthLink program staff in implementing the HealthLink Compliance Program functions, documenting that assessment in writing, and sharing with the HealthLink Compliance Committee.
• Conduct standard random and focused audits of HealthLink program activities to determine compliance with all funding and regulatory sources including but not limited to the lead Health Homes, Medicaid, DOHMH and DOH.
• Record, aggregate, analyze and report results of HealthLink program activity audits, identifying trends and root causes, and making recommendations for program or performance improvements.
• Initiate, facilitate and promote activities to foster HealthLink program staff’s awareness of compliance matters and encourage reporting of compliance issues.
• Monitor compliance with all policies and procedures applicable to HealthLink program.
• Meet and work with the other Senior Program Directors to discuss any findings and implement changes.
• Assist with the program’s chart reviews required by lead Health Homes as well as internal chart reviews as assigned by Senior Program Directors. Report findings to Senior Program Directors.
• Participate in team meetings.
• Lead compliance discussions at monthly site meetings.
• Maintain client confidentiality.
• Attend trainings for continued professional development.
• Other duties as assigned.

Education, Licenses and/or Certifications Required:

• Bachelor’s degree required in either; healthcare administration, business administration or related field.

Minimum Experiences and Skills Required: 

• Five (5) years’ experience in role(s) related to healthcare compliance matters
• Knowledge of federal and New York state healthcare compliance laws and regulations, including HIPAA, a NY SOS § 363-d and 18 NYCRR 521, applicable to Medicaid funded programs
• Excellent written & verbal communication, and interpersonal skills.
• Proficiency in Outlook, Word, and Excel.
• Strong Computer literacy in other Microsoft Office Suite products.

Preferred Qualifications:

• Master’s Degree preferred

Compensation:  $54,600 annually

Status: Part-Time (21 hours/week, or 4 days)
Benefits : CAMBA offers a comprehensive benefits package including health insurance, dental insurance, 403(b) retirement plan with employer match, paid time off (vacation, personal, and sick time), and paid holidays.

CAMBA is an Equal Opportunity Employer. We value a diverse workforce and inclusive workplace. People of color, people with disabilities, and lesbian, gay, bisexual, and transgender people are encouraged to apply. We consider all applicants without regard to race, color, religion, creed, gender, gender identity, gender expression, national origin, age, disability, socio-economic status, marital or veteran status, pregnancy status or sexual orientation.

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