A Compliance Officer or Analyst monitors internal compliance with company policies and also company compliance with local, state and federal laws. Reviews company documents, including contracts and marketing materials; communicates with employees and develops training and internal policy materials.
Park Ridge, NJ Reports to: General Counsel/Compliance Leadership | Full time About us: We deliver HRSN services (screening, navigation, care management and meal delivery for NY Medicaid members under the SCN initiative, working with MCOs and community partners. Responsibilities Build and lead the
SCN/HRSN
compliance program Audit billing, documentation, eligibility, and claims accuracy Ensure data privacy/security compliance for member and referral data Run risk assessments on fraud/waste/abuse, eligibility, and contracts Oversee compliance in Lead Entity and MCO partnerships Train internal teams and partners on requirements Monitor Medicaid/1115 waiver regulations; update policies accordingly Manage complaint/incident resolution and reporting Partner cross functionally with ops, IT, finance, and legal Support audit readiness and respond to state/MCO inquiries Qualifications Bachelor's degree required (JD/MHA/MPH/MBA or
CHC/CCEP/CHPC
preferred) 5+ years healthcare compliance experience, with Medicaid focus Track record building compliance programs, audits, and corrective actions Strong knowledge of Medicaid billing, eligibility, FWA, and HIPAA Ability to translate complex regulations into practice across stakeholders Strong analytical, communication, and cross functional influence skills Nice to Have NY Medicaid, HCBS, behavioral health, or SDOH experience Auditing background in screening/navigation/care coordination Exposure to 1115 waivers or demonstration programs Direct SCN experience not required transferable Medicaid compliance expertise is welcome.
Offer:
Competitive pay, direct access to senior leadership/legal and a chance to build compliance infrastructure for a mission driven program. Send your resume justing@livetomorrow.com
