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VillageCare · 2 days ago

Account Manager, Community Based Services

New York,NY,US

Full-time

Onsite

Entry, Mid Level

$78K/yr - $87K/yr

2+ years exp

VillageCare is a community-based, not-for-profit organization dedicated to serving individuals with chronic care needs. The Account Manager for Community Based Services will oversee daily operations of various healthcare agencies, ensuring regulatory compliance and fostering partnerships to enhance service delivery.

Health CareHospitalNon Profit

Responsibilities

Overseeing the daily operations of Licensed Home Care Agencies, Fiscal Intermediaries, Certified Home Health Agencies, and Social Day Care Centers

Assisting with credentialing, contracting, provider relations, and ensuring regulatory compliance across all functions

Maintaining contracts that support our MLTC and Medicare lines of business

Conducting onboarding sessions for new agencies and performing annual visits to assess Tier 1 and Tier 2 LHCSAs

Collaborating closely with Business Development to strengthen Plan/Provider partnerships, driving membership growth while improving care quality

Overseeing contract accuracy through quality audits

Resolving authorization issues in concert with Care Management

Ensuring compliance with state regulations during Social Day visits

Responding proactively to provider-related issues, ensuring timely resolutions and promoting a collaborative atmosphere

Qualification

NYS healthcare regulationsCMS healthcare regulationsManaged care operationsLong-term care servicesRegulatory compliance knowledgeLeadership capabilitiesEffective communication skillsOrganizational skills

Required

Bachelor's degree

Familiarity with NYS and CMS healthcare regulations

Minimum of 2-4 years of experience in managed care operations, particularly in long-term care services for government programs like Medicaid and Medicare

Strong regulatory and compliance knowledge

Proven leadership capabilities

Effective communication skills