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Ombudsman - NY

extra holidays - extra parental leave - fully flexible

Remote:

Full Remote

Contract:

Full time

Experience:

Mid-level (2-5 years)

Work from:

Albania, New York (USA), United States

Offer summary

Qualifications:

Bachelor's degree required., 4+ years in health care compliance., Experience with investigations and reports., Knowledge of Medicaid is preferred..

Key responsabilities:

Manage Compliance Hotline.
Handle incidents of fraud and abuse.
Oversee refunds for overpayments.
Prepare annual compliance reports.

Public Partnerships Financial Services SME https://www.pplfirst.com/

501 - 1000 Employees

See more Public Partnerships offers

Job description

Public Partnerships LLC (PPL) helps people with disabilities, chronic illnesses, or other long-term health conditions stay at home and “self-direct” their care. Known as consumer direction in New York, this long-term care model empowers people to take control of who provides their services and where. PPL was selected to be the Statewide Fiscal Intermediary for the New York Consumer Directed Personal Assistance Program (CDPAP) starting in 2025. We, along with a diverse alliance of service partners across the state, will be supporting the delivery of culturally sensitive and disability competent care to CDPAP participants. We are looking for people who share our passion for helping New Yorkers live happy, healthy, and independent lives to support CDPAP consumers and their personal assistants across a broad spectrum of services and functions.

Our culture attracts and rewards people who are compassionate, results-oriented, and driven to exceed customer expectations. We desire motivated candidates who are excited to join our fast-paced, consumer-focused environment, and who want to make a difference in helping transform the lives of the people we serve.

Learn more about PPL and CDPAP at https://pplfirst.com/cdpap.

Duties & Responsibilities:
Under the supervision of the Sr. Director of Compliance, NY: Manages Compliance Hotline Handles suspected incidents of fraud, waste and abuse, including reporting to NY DOH, investigating (at DOH direction) and taking remedial action. Handles suspected incidents of abuse, neglect and exploitation of consumers, including reporting investigating and taking remedial action. Handles suspected or actual privacy and security incidents, including reporting investigating and taking remedial action. (162) Oversees refunds when overpayments are identified. (330) Sits on Risk Management Committee and prepares and submits annual risk management summary to NY DOH. Prepares and submits annual certification of compliance program to OMIG on required form (327) Provides regular reporting and updates on activities, issues and trends to the Sr. Director of Compliance. Acts as a champion for a culture of compliance and ethical conduct throughout the organization
Required Skills:
Excellent knowledge of relevant laws, regulations and industry standards Ability to communicate complex compliance issues clearly and effectively Strong analytical, interpersonal, and organizational skills. Proficiency in Microsoft Office technology. Demonstrated competence in reviewing contracts and other legal and regulatory documents. Strong attention to detail. Excellent written and oral communication skills. Strong work ethic and ability to prioritize tasks in a fast-paced, dynamic environment.
Qualifications:
Education:	Bachelor’s degree required.
Experience:	4+ years of relevant work experience in a health care related compliance department. Experience managing health care related investigations and remdial actions Ability to draft clear and concise investigative reports and to communicate complex topics to clients and other stakeholders. Experience with government contracts and familiarity with Medicaid preferred
Working Conditions:
Remote setting. This position is remote in NY. Candidates must reside in the state of NY to be considered.


The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities, or skills of personnel so classified.

Public Partnerships is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PPL, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PPL will not tolerate discrimination or harassment based on any of these characteristics.