Cloud and Things is a leading provider of IT solutions in the public sector. We are dedicated to delivering results and solving complex challenges for our clients. We are looking for individuals who are passionate about making a difference in the world, who are driven by a sense of purpose, and who are committed to excellence. Our team thrives on collaboration, innovation, and delivering high-quality projects that have a significant impact on the public sector's IT landscape.

　　Overview:

　　As a Quality Assurance Analyst, your day-to-day role will be to provide analysis expertise to evaluate the performance of the 1915(c) Children’s Waiver across New York State. This role will be based in Albany, NY, but may include travel across New York State including New York City.

　　Key Responsibilities:

　　Evaluate child/youth’s case for compliance to applicable regulations.

　　Clearly communicate evaluation requirements and follow up.

　　Evaluate documentation against applicable State/Federal regulations.

　　Collect data and documentation to support compliance findings.

　　Utilize technology to convert hard copy documentation to electronic and submit via secure file transfer.

　　Record, summarize, and communicate compliance findings for the Children’s Transformation Program.

　　Assist in determining trends in non-compliance.

　　Make appropriate and timely recommendations to project management.

　　Assist with the ongoing operationalization of project’s processes and procedures.

　　Assist with all internal and external reporting.

　　Build and maintain relationships with stakeholders to provide a high level of customer service.

　　Travelling to provider sites to perform case reviews.

　　Education:

　　A minimum of a bachelor’s degree in public health, healthcare management, psychology, human services, or related field, is preferred.

　　An equivalent combination of advanced education, training, and experience will be considered.

　　Required Qualifications:

　　A minimum of 2 years of A minimum of 2 years of experience as a Healthcare Compliance Analyst, Auditor, Care Manager, or Medicaid Provider, in a role responsible for conducting oversight, compliance audits or chart reviews, or ensuring quality of care.

　　Experience with Medicaid fee-for-service and/or Managed Care billing.

　　Proficiency in MS Excel, MS Word, MS Outlook, MS Visio, MS PowerPoint and MS SharePoint.

　　Preferred/Desired Qualifications:

　　Extensive knowledge of, and experience with, Home and Community-Based Services Waiver programs, including the 1915(c) NYS Children’s Waiver, either as a provider or compliance officer.

　　Experience working with eMedNY, CANS-NY, UAS-NY, Medicaid Health Homes, Medicaid Managed Care Organizations (MMCOs), or other related programs/systems.

　　Experience with NYS Medicaid billing, including the use of various Electronic Health Records (EHR) systems.

　　Experience working with Office of Mental Health (OMH), Office for People with Developmental Disabilities (OPWDD), or Office of Children and Families (OCFS).

　　Experience with compliance audits or chart reviews.

　　Ability to work with and relate to staff and demonstrate active listening skills.

　　Process oriented and results-driven work strategy.

　　Ability to foster teamwork with all levels of management and staff.

　　Ability to work well independently and within a team.

　　Exceptional customer service relationship techniques, including superior verbal and written communication skills.

　　Excellent accuracy and attention to detail.

　　Experience in meeting deadlines and adhering to strict standards of performance.

　　Cloud and Things comply with all applicable federal, state, and local laws regarding recruitment and hiring. All qualified applicants are considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other category protected by applicable federal, state, or local laws.