Village Care

Role Description Join VillageCare as a Full-Time Senior Financial Data Analyst in the dynamic healthcare sector and play a pivotal role in shaping the financial strategies that impact our community. This position offers work-from-home flexibility, allowing you to balance your professional responsibilities with your personal life while contributing to meaningful healthcare solutions. As a Senior Financial Data Analyst at VillageCare, you will: - Develop, document, and maintain reports and analytics that empower leadership with key insights to drive financial success. - Ensure the accuracy and timeliness of routine and ad hoc reports. - Collaborate closely with both internal and external customers to guarantee successful report roll-ups and high customer satisfaction. - Utilize advanced tools such as SQL, Tableau, and RedShift to create customized dashboards for the Finance department. - Work with the IT team to automate reports for efficient metric monitoring. - Support the monthly close process and conduct claim reserve analysis. - Create member economics reports to aid strategic decision-making. - Lead medical claims reinsurance reporting and support the preparation of provider group financial statements. - Ensure compliance with regulatory reporting requirements while demonstrating VillageCare's commitment to Service Excellence. Qualifications - Minimum 5 years of relevant professional work experience. - Experience working in an actuarial function with a focus on building claims reserves, updating claims triangles, and IBNR estimation. - Ability to perform complex data analysis and report/dashboard development in a healthcare setting. - Excellent technical skills (MS Excel, SQL, Tableau, Access, Python, etc.). - Capacity to multi-task at a high detail-oriented level. - Strong communication skills (verbal, written, presentation, interpersonal). - Strong analytical and logical skills paired with strong attention to detail. - Bachelor's degree in Healthcare, Finance, or a relevant field or equivalent years of experience required. Requirements - Proficiency in technical tools such as MS Excel, SQL, Tableau, Access, and Python. - Ability to conduct complex data analyses and develop insightful reports and dashboards in a healthcare environment. - Strong attention to detail and ability to multi-task. - Strong communication and presentation capabilities. Benefits - Competitive salary range of $87,647.11 to $98,603.00. - Work-from-home flexibility. - Opportunity to contribute to meaningful healthcare solutions. Company Description 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. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

Role Description The Care Coordinator Supervisor is responsible for the day-to-day oversight and supervision of the Care Coordinator team within the Care Management department. This role is accountable for ensuring Care Coordinators deliver exceptional customer service, timely follow-up, and seamless support to Care Managers, members, and providers. The Care Coordinator Supervisor will lead the team in meeting performance goals and promote a culture of service excellence by fostering accountability, engagement, and collaboration, while ensuring compliance with organizational standards and regulatory requirements. Qualifications - Minimum of 2 years of supervisory experience in healthcare - Demonstrated proficiency in Windows and Microsoft Office Suite - Experience with care management EMR platforms required - Bilingual is preferred - Associate degree is required; bachelor's degree is preferred Requirements - Must reside within the New York Tri-State Area - NY, NJ, or CT - Schedule: Monday - Friday 9am-5pm - Compensation: $58,039 - $65,294 Company Description 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 number of Medicaid and Medicare managed care plans, and through our Assisted Living Program. VillageCare has delivered quality health care and social services to individuals residing within New York City for over 45 years. Our service area now includes all five boroughs of NYC, as well as Westchester, Nassau, and Putnam counties.

Role Description Join VillageCare as a Full-Time Medicare Risk Adjustment Coding Manager and enjoy the thrill of playing a vital role in healthcare's future while working from the comfort of your home. This position offers unparalleled flexibility, allowing you to balance personal and professional commitments seamlessly. As a key player in our organization, you will lead initiatives that directly impact patient care and financial outcomes. The Risk Adjustment Coding Manager at VillageCare plays a crucial role in enhancing healthcare quality and operational efficiency. This position is responsible for: - Coordinating Risk Adjustment and Quality coding operations. - Emphasizing documentation integrity across both areas. - Overseeing retrospective and prospective chart review programs. - Supervising the Risk Adjustment coding staff. - Managing day-to-day vendor operations. - Acting as the operational bridge between Risk Adjustment and the HEDIS/Quality abstraction team. - Ensuring effective utilization of all medical record interactions for Hierarchical Condition Category (HCC) accuracy and closing quality gaps. This role aims to achieve year-over-year improvements in: - Risk Adjustment accuracy. - Risk Adjustment Factor (RAF) performance. - STARs quality measure outcomes. Qualifications - CPC, CPMA, CRC, CCS-P, CCS, RHIA, or RHIT certification. - 5+ years of Medicare Risk Adjustment coding experience, including work on RADV audits. - Strong knowledge of ICD-10 and CPT codes. - Excellent communication skills to facilitate collaboration within the department and with cross-functional teams. - Bachelor's degree in Business Administration, Finance, or a relevant field, or equivalent work experience. Requirements - Proficiency in HEDIS measure specifications and quality gap closure operations is highly preferred. - Previous experience using electronic medical record systems. Benefits - Compensation ranging from $102,549.17 to $115,367.82 annually. - Flexible work schedule: Monday - Friday, 9:00am - 5:00pm.

Role Description Join VillageCare as the Manager of Broker Sales Operations and embrace an exciting opportunity to shape the healthcare landscape from the comfort of your home. This pivotal role allows you to leverage your problem-solving skills and customer-centric mindset while engaging with a dynamic team committed to excellence. Experience the thrill of driving sales operations in a flexible, high-performance environment that values integrity and innovation. Your contributions will directly impact our service delivery in New York, NY, and beyond. The Broker Manager - Sales Operations at VillageCare is vital in upholding the operational integrity and efficiency of our broker sales infrastructure. This role encompasses comprehensive responsibilities, including: - Broker onboarding - System configuration - Enrollment tracking - Payment alignment - Overseeing operational platforms with external vendors like Convey and Connecture Acting as a crucial liaison between Broker Sales, Finance, Compliance, and IT, the Broker Manager ensures that brokers are seamlessly integrated into all systems, facilitating their swift transition to a Ready-to-Sell status. By effectively identifying and resolving system errors that could affect broker readiness, enrollment processing, and compensation accuracy, this position strengthens operational cohesion. Furthermore, the Broker Manager plays a key role in optimizing processes to reduce enrollment and payment errors, fostering broker confidence, and supporting scalable growth through structured oversight and accountability. Qualifications - Expertise in operational platforms such as Convey and Salesforce - Deep understanding of broker system setup and readiness-to-sell oversight - Strong analytical and problem-solving abilities - At least five years of experience in broker or sales operations, with a focus on healthcare insurance operations - Knowledge of broker compensation structures - Excellent organizational skills - Familiarity with Medicare Advantage and related healthcare products preferred Requirements - Broker System Setup & Readiness-to-Sell Oversight - Convey Platform Oversight & System Integrity - Enrollment Processing & Connecture Application Oversight - Broker Payment Oversight & Compensation Alignment - Operational Process Management & Accountability - Broker Operational Support & Issue Resolution - Cross-Functional Collaboration - Operational Risk Management & Continuous Improvement Experience - Bachelor's degree preferred (Business Healthcare Administration or related field) - 5+ years of experience in broker operations, sales operations or healthcare insurance operations - Strong experience working with broker operational systems including Convey, Connecture, and Salesforce - Experience supporting broker onboarding readiness-to-sell processes and enrollment operations - Strong understanding of broker compensation structures and payment workflows - Experience identifying and resolving system and operational issues - Knowledge of Medicare Advantage, MAP, MLTC and related healthcare products preferred - Strong organizational, analytical and operational problem-solving skills - Ability to manage multiple systems workflows and operational priorities Join our team today! If you have these qualities and meet the basic job requirements, we'd love to have you on our team. Apply now using our online application!

Role Description Join VillageCare as a Full-Time Senior Financial Data Analyst in the dynamic healthcare sector and play a pivotal role in shaping the financial strategies that impact our community. This position offers work-from-home flexibility, allowing you to balance your professional responsibilities with your personal life while contributing to meaningful healthcare solutions. Based in New York, NY, you will be part of a dedicated team that values excellence and customer-centricity in its mission to provide outstanding healthcare services. Your analytical expertise will drive decision-making in an energetic and forward-thinking environment. As a Senior Financial Data Analyst at VillageCare, you will: - Develop, document, and maintain reports and analytics that empower leadership with key insights to drive financial success. - Ensure the accuracy and timeliness of routine and ad hoc reports. - Collaborate closely with both internal and external customers to guarantee successful report roll-ups and high customer satisfaction. - Utilize advanced tools such as SQL, Tableau, and RedShift to create customized dashboards for the Finance department. - Work with the IT team to automate reports for efficient metric monitoring. - Support the monthly close process and conduct claim reserve analysis. - Create member economics reports to aid strategic decision-making. - Lead medical claims reinsurance reporting and support the preparation of provider group financial statements. - Ensure compliance with regulatory reporting requirements. Qualifications - Minimum 5 years of relevant professional work experience. - Experience working in an actuarial function with a focus on building the claims reserve, updating claims triangles, and IBNR estimation. - Ability to perform complex data analysis and report/dashboard development in a healthcare setting. - Excellent technical skills (MS Excel, SQL, Tableau, Access, Python, etc.). - Capacity to multi-task at a high detail-oriented level. - Strong communication skills (verbal, written, presentation, interpersonal). - Strong analytical and logical skills paired with strong attention to detail. - Bachelor's degree in Healthcare, Finance, or a relevant field or equivalent years of experience required. Requirements - Must reside in NY, NJ, or CT. Benefits - Competitive salary range of $87,647.11 to $98,603.00. - Work-from-home flexibility. Company Description 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.

Role Description Join VillageCare as a Full Time Clinical Risk Coordinator and become an integral part of our mission to enhance health care quality while ensuring patient safety. In this pivotal role, you will have the opportunity to implement innovative risk management strategies that directly impact the well-being of our clients. Your day to day as a Clinical Risk Coordinator includes: - Scheduling RN Assessor visits to members. - Creating comprehensive schedules, reports, and documentation to assist Supervisors. - Providing essential office support to the team. - Engaging with members over the phone to arrange RN appointments. - Entering scheduling data and maintaining accurate schedules through Outlook. - Maintaining staff and client information in the database. - Overseeing staff and client statistics. - Conducting audits for timely submission of RN paperwork. - Fulfilling other job-related duties as assigned. Qualifications - A minimum of 2-3 years of healthcare experience, ideally in a support or coordination role. - Bilingual capabilities in Spanish, Russian, Chinese, Bengali, or Creole preferred. - Proficient in Microsoft Word, Outlook, and Excel. - Excellent written and communication skills. - High School diploma required; Associate's degree preferred. - Valid NYS identification or NYS Driver License. Requirements - 2-3 years of healthcare experience preferred. - Bilingual preferred: Spanish, Russian, Chinese, Bengali, Creole. - Proficient in Microsoft Word, Outlook, and Excel. - Excellent written and communication skills. - High School diploma required; Associate's degree preferred. - Valid NYS identification or NYS Driver License. Benefits - Competitive pay structure ranging from $25.01 to $28.14 per hour. - Opportunity to make a difference in health care. - Professional growth fostered within a dynamic team. Company Description 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. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

Role Description Join VillageCare as a Full-Time Medicare Risk Adjustment Coding Manager and enjoy the thrill of playing a vital role in healthcare's future while working from the comfort of your home. This position offers unparalleled flexibility, allowing you to balance personal and professional commitments seamlessly. The Risk Adjustment Coding Manager at VillageCare plays a crucial role in enhancing healthcare quality and operational efficiency. This position is responsible for: - Coordinating Risk Adjustment and Quality coding operations. - Emphasizing documentation integrity across both areas. - Overseeing retrospective and prospective chart review programs. - Supervising the Risk Adjustment coding staff. - Managing day-to-day vendor operations. - Acting as the operational bridge between Risk Adjustment and the HEDIS/Quality abstraction team. - Ensuring effective utilization of all medical record interactions for Hierarchical Condition Category (HCC) accuracy and closing quality gaps. This role aims to achieve year-over-year improvements in: - Risk Adjustment accuracy. - Risk Adjustment Factor (RAF) performance. - STARs quality measure outcomes, directly impacting patient care and organizational success. Qualifications - CPC, CPMA, CRC, CCS-P, CCS, RHIA, or RHIT certification. - 5+ years of Medicare Risk Adjustment coding experience, including work on RADV audits. - Experience with HEDIS measure specifications and quality gap closure operations preferred. - Strong knowledge of ICD-10 and CPT codes. - Previous experience using electronic medical record systems. - Excellent communication skills to facilitate collaboration within the department and with cross-functional teams. - Bachelor's degree in Business Administration, Finance, or a relevant field, or equivalent work experience required. Requirements - Robust set of skills and qualifications as outlined in the qualifications section. Benefits - Compensation ranges from $102,549.17 to $115,367.82 annually.

Role Description Join VillageCare as the Manager of Broker Sales Operations and embrace an exciting opportunity to shape the healthcare landscape from the comfort of your home. This pivotal role allows you to leverage your problem-solving skills and customer-centric mindset while engaging with a dynamic team committed to excellence. Experience the thrill of driving sales operations in a flexible, high-performance environment that values integrity and innovation. Your contributions will directly impact our service delivery in New York, NY, and beyond. The Broker Manager - Sales Operations at VillageCare is vital in upholding the operational integrity and efficiency of our broker sales infrastructure. This role encompasses comprehensive responsibilities, including: - Broker onboarding - System configuration - Enrollment tracking - Payment alignment - Overseeing operational platforms with external vendors like Convey and Connecture By effectively identifying and resolving system errors that could affect broker readiness, enrollment processing, and compensation accuracy, this position strengthens operational cohesion. Ultimately, the role ensures that brokers operate efficiently, members gain timely access to benefits, and compensation remains accurate, promoting sustainable growth within our organization. Qualifications - Expertise in operational platforms such as Convey and Salesforce - Deep understanding of broker system setup and readiness-to-sell oversight - Strong analytical and problem-solving abilities - At least five years of experience in broker or sales operations, with a focus on healthcare insurance operations - Knowledge of broker compensation structures - Excellent organizational skills - Familiarity with Medicare Advantage and related healthcare products preferred Requirements - Broker System Setup & Readiness-to-Sell Oversight - Convey Platform Oversight & System Integrity - Enrollment Processing & Connecture Application Oversight - Broker Payment Oversight & Compensation Alignment - Operational Process Management & Accountability - Broker Operational Support & Issue Resolution - Cross-Functional Collaboration - Operational Risk Management & Continuous Improvement Experience - Bachelor's degree preferred (Business Healthcare Administration or related field) - 5+ years of experience in broker operations, sales operations or healthcare insurance operations - Strong experience working with broker operational systems including Convey, Connecture, and Salesforce - Experience supporting broker onboarding readiness-to-sell processes and enrollment operations - Strong understanding of broker compensation structures and payment workflows - Experience identifying and resolving system and operational issues - Knowledge of Medicare Advantage, MAP, MLTC and related healthcare products preferred - Strong organizational, analytical and operational problem-solving skills - Ability to manage multiple systems workflows and operational priorities Join our team today! If you have these qualities and meet the basic job requirements, we'd love to have you on our team. Apply now using our online application!

Role Description Join VillageCare as a Full Time Risk Adjustment Coder and embrace the opportunity to work remotely while making a significant impact in the Health Care sector. This role offers the flexibility of a work-from-home environment, allowing you to balance your professional and personal commitments without the daily commute. You'll be part of a dynamic team that thrives on innovation, problem-solving, and a customer-centric approach, all while contributing to the excellence and integrity that VillageCare stands for. Your responsibilities will include: - Performing critical code abstraction of medical records, ensuring accurate assignment of ICD-9-CM, ICD-10-CM, CPT, and HCPCS codes supported by clinical documentation. - Conducting comprehensive reviews of medical records to validate that documentation meets CMS requirements, including provider signatures and relevant dates. - Identifying improvement opportunities in documentation and coding processes. - Participating in quality initiatives that enhance overall outcomes. - Maintaining current knowledge of coding standards and regulations. - Supporting the Medicare Risk Adjustment team in educating providers on compliance and consistency. - Reporting findings from audits and assisting in analysis. - Maintaining a minimum accuracy of 95% on coding quality audits while meeting productivity requirements. Qualifications - Strong knowledge of clinical terminology, disease processes, anatomy/physiology, and pharmacology. - 5 recent years of HCC/Risk Adjustment and/or inpatient coding experience. - Certified through AAPC or AHIMA (CPC, CRC, RHIT, or RHIA). - Must reside in NY, NJ, or CT. Requirements - Exceptional attention to detail. - Basic computer skills. - Ability to maintain a productive home office environment with high-speed internet. - Strong knowledge of claims processing procedures and systems. - Understanding of state, federal, and Medicare regulations and Coordination of Benefits applications. - Strong problem-solving skills and a commitment to coding excellence. Benefits - PTO package. - 10 Paid Holidays. - Personal and Sick time. - Medical/Dental/Vision. - HRA/FSA. - Education Reimbursement. - Retirement Savings 403(b). - Life and Disability. - Commuter Benefits. - Paid Family Leave. - Additional Employee Discounts. Company Description 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.

Role Description Join VillageCare as a Full Time UAS RN Reviewer and elevate your nursing career in an innovative, fully remote environment! This role offers the chance to apply your expertise in a customer-focused healthcare setting while being a crucial part of a dynamic, forward-thinking team. With a competitive salary ranging from $87,647.11 to $98,603.00, you'll find the satisfaction of enhancing patient care from the comfort of your own home. Embrace the flexibility of a remote position that fosters high performance and integrity in everything we do. Bring your problem-solving skills and commitment to excellence to a role that truly makes a difference in people's lives. Must reside within the New York Tri-State Area - NY, NJ, or CT. As a new UAS RN Reviewer at VillageCare, your day-to-day responsibilities will include: - Performing Quality Assurance reviews completed by the Nurse Assessors - Reviewing completed UAS-NY for accuracy, completeness and timeliness of finalization - Reviewing all documentation for appropriateness of care and consistency of documentation - Review of all responses and comments in community, functional and mental health assessments for consistency - Utilizing QAS reports to maintain knowledge of current trends related to quality measures and risk score - Reviewing proposed plan of care/ATSP to ensure that it reflects the clinical and psychosocial needs of the member - Communicating with the Nurse Assessor for requested revisions and clarification in order to finalize assessment - Following up to ensure timely completion of assignments and submission of original paperwork to the office - Providing guidance and training to the Nurse Assessors related to accurate completion of the UAS-NY - Monitoring finalization of UAS-NY in order to ensure adherence with State policy - Collaborating with Care Management in order to ensure plan of care is in alignment with the needs of the member Expect to work Monday through Friday from 9 AM to 5 PM, allowing for a structured schedule that promotes a healthy work-life balance. You will collaborate with a high-performing team, participating in regular meetings to discuss cases and share best practices, all within a flexible and professional virtual environment. Qualifications - Strong analytical abilities for performing quality assurance reviews - Attention to detail for reviewing community, functional, and mental health assessments - Proficiency in essential software and tools, including the QCSS Assessment Analyzer - Effective communication skills for collaborating with Nurse Assessors Requirements - Must reside within the New York Tri-State Area - NY, NJ, or CT Benefits - Generous PTO package - 10 Paid Holidays - Personal and Sick time - Medical/Dental/Vision - HRA/FSA - Education Reimbursement - Retirement Savings 403(b) - Life & Disability - Commuter Benefits - Paid Family Leave - Additional Employee Discounts Company Description 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.