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Audit & Compliance Analyst (DSRIP)

Department: PCG Health
Location: Albany, NY

Audit & Compliance Analyst (DSRIP) in Albany, NY - 2 Openings

The Audit & Compliance Analyst is responsible for assisting the New York Department of Health (NYSDOH) to achieve the goals established through its Delivery System Reform Incentive Payment Program (DSRIP). The NYSDOH has launched a multi-year initiative designed to transform the way health services are delivered to New York Stateís Medicaid members. Audit & Compliance Analysts will be responsible for assisting in the monitoring, reviewing, and reporting on the performance of participating provider networks, known as Performing Provider Systems (PPSs), who have committed to creating and sustaining an integrated, high performing health care delivery system by improving health and reducing costs.

Responsibilities:

  • Serve as part of a team in conducting risk assessments, performance audits, and compliance reviews of Performing Provider Systems (PPS). This work will include validating PPS performance against completed process milestones; conducting site visits to verify performance; and complete monthly/quarterly reports to calculate achievement values in order to determine DSRIP payments earned.
  • Be able to understand and use data to assess PPS performance.
  • Track deliverables owed by PPS and determine performance, as well as payments earned.
  • Complete quarterly report results and tracking statewide performance.
  • Additional responsibilities as assigned.
  • Perform PPS program and compliance reviews under defined timeframes.
  • Draft reports and deliver on all the services the client has purchased or needs.
  • Identify at-risk projects and providers in accordance with defined protocols.
  • Assist in the preparation of program review training materials and staff development.

Qualifications:

  • Bachelorís degree is required.
  • Understanding of healthcare delivery systems, strong preference given to those candidates with experience working within the Medicaid program.
  • Experience performing program and/or financial audits within the healthcare sector.
  • Ability to work as part of a team independently with minimal supervision.
  • Ability to travel frequently within a defined geographic region within New York State.
  • Work with colleagues to continuously improve monitoring processes.
  • Excellent communication skills including business writing, and ability to make presentations to various audiences.
  • Maintain security and confidentiality of all protected health information encountered during performance.
  • Well organized with a high degree of accuracy and attention to detail.
  • Must be able to learn a significant amount of information in a short time-frame.
  • Effectively work within multiple deadlines and prioritize assignments.

Relevant Experience:

  • 1-3 years of relevant work experience required.
  • Proficient in use of applicable software programs, including Microsoft Word and Excel.

 

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. VEVRAA Federal Contractor.  

Staffing Solutions Organization LLC is an e-Verify participant.

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