Compliance Auditor

Village Center for Care, Inc.; New York (NY); Hybrid; USD 78,000 - 87,000; Full time

Job summary

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible.

Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City

Qualifications

• Bachelor's degree.
• Minimum 2 years of related experience.
• Knowledge of CMS and NY DOH Medicare/Medicaid regulations; familiarity with claims and care management processes.
• Strong analytical, communication, and project management skills; proficiency in MS Office.
• Willingness to pursue CIA and CHC certifications.

Responsibilities

• Plan and conduct compliance audits across operational areas and provider/FDR networks
• Define audit objectives, scope, risks, and testing procedures; perform sample testing
• Maintain clear, complete workpapers and draft audit reports with practical recommendations
• Partner with stakeholders on root-cause analysis and track corrective action plans to completion
• Identify potential fraud, waste, and abuse risks and support mock audits for regulators

Skills

CMS regulations knowledge

Regulatory auditing

Analytical skills

Communication

Project management

Education

Bachelor's degree

Tools

MS Office

Job description

Position: Compliance Auditor

Location: Hybrid (Must Reside in NY/NJ/CT)

Work Schedule: Monday - Friday, 9:00am - 5:00pm

Compensation: $77,506.87 - $87,195.23 Annual Salary

Our Organization

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

Role Summary

As an entry-level Compliance Auditor, you will help ensure the health plan's operations and delegated entities meet Medicare and Medicaid requirements. This role supports regulatory readiness and strengthens controls through structured audit work.

• Plan and conduct compliance audits across operational areas and provider/FDR networks
• Define audit objectives, scope, risks, and testing procedures; perform sample testing
• Maintain clear, complete workpapers and draft audit reports with practical recommendations
• Partner with stakeholders on root-cause analysis and track corrective action plans to completion
• Identify potential fraud, waste, and abuse risks and support mock audits for regulators

Required Qualifications

• Bachelor's degree
• Minimum 2 years of related experience
• Knowledge of CMS and NY DOH Medicare/Medicaid regulations; familiarity with claims and care management processes
• Strong analytical, communication, and project management skills; proficiency in MS Office
• Willingness to pursue CIA and CHC certifications

A Typical Workday

Your day is structured around a clear audit plan and steady communication. Working with work-from-home flexibility, you'll start by reviewing the current audit timeline, open questions, and documentation received from the area under review. You'll spend focused time organizing evidence, validating what you're seeing against regulatory expectations, and summarizing observations so they are easy for others to follow. As the day progresses, you'll join check-ins with the Director of Compliance & Internal Audit and audit participants to confirm status, clarify items that need follow-up, and keep the engagement moving on schedule. You'll also refine draft narratives and visuals for reporting so stakeholders can quickly understand risk, impact, and next steps. Before signing off, you'll update tracking for open items and ensure deliverables are ready for timely review.