Compliance Auditor
About The Position
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. 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.
Requirements
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
