(TEMP) Associate, Case Manager Internal Audit (RN or LCSW)

| Greater NYC Area | Hybrid
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#communityhealth #healthcare

About Us:

Cityblock Health is the first tech-driven provider for communities with complex needs, bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s Sidewalk Labs and some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities, one block at a time. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are—bringing care into the home and neighborhoods through our community-based care teams.

In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.

Over the next year, we’ll grow quickly to bring better care to many more members and their communities. We will get started in new markets, each with their own operating structure and care teams, and continue to grow in the communities where we are working already. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community.

Our work is grounded in a belief in the power of a diverse community. To deliver a radically better experience of care to our members and advance equity in the communities we serve, we strive to make our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bridging together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels like they belong, are valued, respected, and celebrated as a part of our community. 

Our Values:

  • Aim for Understanding
  • Be All In
  • Bring Your Whole Self
  • Lean Into Discomfort
  • Put Members First

About the Role: 

We are seeking Temp Associate, Care Management Auditing to help manage our case management documentation compliance. You’ll work closely with our care team members, care team leads, Quality team, and Market Operations team. This is an exceptional opportunity for a process-oriented, hungry self-starter who is interested in a cross-functional role at a rapidly scaling organization. 

  • Participate in multiple audits and related projects, make judgements around objectives and scope, ensure effective and efficient audit execution.
  • Assist with identifying non-compliance with regulatory requirements and issue corrective action plans (CAPs) as required.
  • Assist with the management corrective action plans (CAPs)/recommendations when deficiencies are identified and document follow-up to completion.
  • Aggregate and analyze audit findings into a reportable format and report to appropriate departments.
  • Audit and validate Case Management required reporting to ensure continued compliance with delegated responsibilities.
  • Develop, prepare and analyze performance reports for management review to various levels of management.
  • Participate in Care Management/Clinical meetings and training.
  • Assist with planning and implementation of formal education sessions to Market Ops teams to address non-compliance issues.
  • Maintain delegation audit calendar, tools, policies and reporting templates.
  • Assist with preparation of documents for CMS and/or other regulatory audit audits as needed by our health plan partners.
  • Assist in the development and maintenance of policies and procedures.
  • Other projects and duties as assigned.

Requirements for the Role:  

  • Registered Nurse, or Social Worker with current and active license.
  • 2 years of experience in clinical auditing such as case management, HEDIS, or compliance.
  • 2 years of experience in NCQA, URAC, and/or CMS regulations
  • 2 years of experience in Case Management
  • Strong knowledge of managed care principles and delivery systems, medical management process, accreditation and regulatory standards delegated oversight processes, and workflow systems.
  • Strong understanding in Medicaid and Medicare requirements across multiple states

How We Define Success: 

  • Self-starter and able to work independently.
  • Knowledge of audit processes and applicable federal regulatory and accredited standards.
  • Must possess a high level of organizational skills to maintain accurate records and documentation.
  • Attention to detail with analytical and problem-solving capabilities.
  • Ability to take initiative and see tasks to completion.
  • Experience with Google suite of products
  • Excellent verbal and written communication skills and able to maintain positive relations with internal and external partners at all levels.
  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.

Nice to Have, But Not Required:

  • Prior experience working in a start-up setting 
  • Prior experience working with Google products
  • CCM or CPHQ certification

What We’d Like From You: 

  • A resume and/or LinkedIn profile 
  • A short cover letter


Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. 

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means. 

Covid 19 Update - Please Read:

Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine.  Any individuals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock.  Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption.  Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. This vaccination requirement is based, in part, on recently established government requirements.  The requirement is also based on the safety and effectiveness of the vaccine in protecting against COVID-19, and our shared responsibility for the health and safety of members, colleagues, and community.

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Location

New York, NY 11201

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