Senior Healthcare Vendor Compliance Auditor

VNS Health; New York (NY); On-site; USD 93,000 - 117,000; Full time

Benefits offered by this job

Referral bonus opportunities

Generous PTO and holidays

Comprehensive health insurance for you

Employer-matched retirement savings

Tuition reimbursement

Professional growth opportunities

Internal mobility and CEU credits

Job summary

VNS Health is seeking a Compliance Auditor responsible for planning, coordinating, and conducting comprehensive audits to assess adherence to regulatory requirements, contractual obligations, and internal policies. The role involves providing updates to Management, participating in investigations, and overseeing pre-delegation and annual audits for delegated entities to drive improvement.

The position acts as a SME, mentoring staff and collaborating with Legal, Compliance, Quality, and

Qualifications

• Bachelor's Degree or equivalent education and/or related experience required
• A least 4 years of audit experience in compliance, delegation oversight, or audit within the healthcare industry required
• Demonstrated experience in delivering training programs and making presentations to internal staff and providers required
• Knowledge of New York State Department of Health (SDOH), CMS requirements required
• Highly developed analytical and critical thinking skills required
• Ability to manage multiple priorities, projects and meet deadlines required
• Excellent verbal and written communication skills required
• Proficient in Microsoft Office, Excel, and PowerPoint required

Responsibilities

• Analyzes and interprets contractual, state, and federal regulatory requirements; stays updated on regulatory changes and assesses impact on the organization
• Participates in and conducts compliance functions; develops audit tools and validates implementation of new requirements and corrective action plans
• Collaborates with cross-functional teams to address compliance challenges and implement effective solutions; prepares reports for internal Committees and external entities
• Works with internal business units and external entities to correct performance deficiencies
• Delivers regulatory trainings for internal business units and/or external entities
• Facilitates vendor-related projects and tracks program effectiveness with Delegation Oversight Audit management
• Assists in development, review, and updating of policies and procedures to align with regulatory requirements
• Conducts audits of VNS Health Health Plans/Vendors
• Updates audit tools based on regulatory changes
• Leads entrance/exit calls and conferences with delegates and cross-functional teams to address performance deficiencies
• Performs other duties as assigned
• Participates in special projects

Skills

Auditing

Regulatory knowledge

Analytical thinking

Communication skills

Education

Bachelor's degree or equivalent

Tools

Microsoft Office

Job description

VNS Health is seeking a Compliance Auditor responsible for planning, coordinating, and conducting comprehensive audits to assess adherence to regulatory requirements, contractual obligations, and internal policies. The role involves providing updates to Management, participating in investigations, and overseeing pre-delegation and annual audits for delegated entities to drive improvement.

The position acts as a SME, mentoring staff and collaborating with Legal, Compliance, Quality, and