Field Compliance Auditor – Healthcare Contracts

VNS Health; New York (NY); On-site; USD 70,000 - 88,000; Full time

Benefits offered by this job

Referral bonus

PTO & holidays

Health insurance

Retirement plan

Wellness programs

FSAs

Tuition reimbursement

Career growth

Internal mobility

Job summary

VNS Health in New York seeks an Audit Specialist to conduct regulatory, credentialing, and contractual compliance audits of SADC, CDPAS/FI, and LHCSA providers. You will review documents, assess adherence to NYS rules and VNS Health standards, and draft findings and corrective actions.

This role requires travel across Downstate NYC, up to 90%, and close collaboration with Network, Compliance, Quality, Operations, and Claims teams to drive improvements and regulatory readiness.

Qualifications

• Associate's Degree or equivalent work experience required.
• Minimum 3 years contract-related health care experience.
• Familiarity with Medicaid/Medicare compensation methodologies.
• Resides in Downstate NY preferred.
• Travel up to 90% required.

Responsibilities

• Conducts scheduled and targeted on-site compliance audits for SADC, CDPAS/FI, and LHCSA providers.
• Evaluates provider adherence to regulatory requirements, contractual obligations, credentialing standards, and VNS Health policies.
• Reviews provider documentation, operational processes, staffing qualifications, training records, and required regulatory materials.
• Develops audit findings, scoring summaries, corrective action requirements, and recommendations for improvement.
• Monitors provider corrective action plans and perform follow-up reviews to validate remediation.
• Maintains audit tracking, documentation, reporting, and audit calendars.
• Identifies trends, recurring deficiencies, and opportunities for provider education and process improvement.
• Collaborates with Network, Compliance, Quality, Operations, Claims, and other internal teams on provider performance concerns.
• Supports regulatory audits and special projects as assigned.
• Travels throughout Downstate NYC to conduct on-site audits, complaint investigations, and regulatory reviews; 90% travel.
• Communicates proactively and collaborate with internal departments to ensure regulatory alignment, operational efficiency, and effective resolution of compliance matters.
• Participates in special projects and performs other duties as assigned.

Skills

Regulatory compliance

Auditing

Travel up to 90%

Medicare/Medicaid knowledge

Education

Associate's degree or equivalent experience

Bachelor's degree in Business Administration/Finance/Accounting or related field preferred

Tools

Regulatory guidelines

Job description

VNS Health in New York seeks an Audit Specialist to conduct regulatory, credentialing, and contractual compliance audits of SADC, CDPAS/FI, and LHCSA providers. You will review documents, assess adherence to NYS rules and VNS Health standards, and draft findings and corrective actions.

This role requires travel across Downstate NYC, up to 90%, and close collaboration with Network, Compliance, Quality, Operations, and Claims teams to drive improvements and regulatory readiness.