Sr. Associate, CM Delegation Audit

| Greater NYC Area
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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 along with some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities. 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 and Virtual Care offerings.

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. 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 close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included 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 a talented Senior Associate, Care Management Auditing to help manage our care 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. 

  • Manage multiple audits and related projects, make judgements around objectives and scope, ensure effective and efficient audit execution.
  • Monitor, analyze data reported, and identify non-compliance with regulatory requirements and issue corrective action plans (CAPs) as required.
  • Develop, implement and manage corrective action plans (CAPs)/recommendations when deficiencies are identified and document follow-up to completion.
  • Act as an operational expert and interventionist through communication, education and design of programs and strategies to assist delegated entities to meet regulatory and accrediting standards.
  • Aggregate and analyze audit findings into a reportable format and report to appropriate departments.
  • Evaluate and validate Care Management required reporting to ensure continued compliance with delegated responsibilities.
  • Develop, prepare and analyze performance reports for management review and present to various levels of management and committees.
  • Participate in Care Management/Clinical Committee meetings.
  • Assist with planning and implementation of formal education sessions to Market Ops teams to address non-compliance issues.
  • Collaborate with internal business units to support reporting requests and maintain reports.
  • Works with the Delegation Oversight Manager to develop and 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.
  • Develop and maintain policies and procedures.
  • Other projects and duties as assigned.

Preferred Requirements for the Role:  

  • Bachelor’s degree in Nursing, or Social Work, or Masters in Healthcare Administration preferred; however, an equivalent combination of education and experience that provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements
  • Minimum 2 year accreditation experience; NCQA, URAC, and/or CMS regulations. 
  • Strong knowledge of managed care principles and delivery systems, medical management process, accreditation and regulatory standards delegated oversight processes, and workflow systems.
  • Knowledge of managed care compliance, CMS regulatory and NCQA standards.
  • Strong ability to quickly build relationships and trust with our clinical and clinical ops teams 
  • 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

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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Technology we use

  • Engineering
  • Product
    • PythonLanguages
    • ScalaLanguages
    • SqlLanguages
    • ReactLibraries
    • Node.jsFrameworks
    • PostgreSQLDatabases
    • Google AnalyticsAnalytics
    • LookerAnalytics
    • ConfluenceManagement
    • JIRAManagement

Location

Cityblock is committed to flexible work. Due to the COVID-19 pandemic, most of our business team is operating remotely.

An Insider's view of Cityblock Health

What's something quirky about your company?

There's a slack channel for everything - plants, podcasts, cooking, baking, hiking, Peloton - I love it

Tina

Implementation Manager

How does the company support your career growth?

My manager and I do monthly check-ins on career development during our 1:1s. This has been a great opportunity to address areas I'd like to improve and set up an action plan.

Jose

Senior Software Engineer

What are Cityblock Health Perks + Benefits

Cityblock Health Benefits Overview

To properly care for our members and advance equity in the communities we serve, we believe our own team must be diverse and inclusive. We take to heart what it means to bring your whole self and actively work to build representation, build belonging and advance justice. Our goal is to ensure everyone at Cityblock feels respected, celebrated, and part of our community.

Culture
Volunteer in local community
Partners with Nonprofits
Friends outside of work
Eat lunch together
Intracompany committees
Daily sync
Open door policy
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Open office floor plan
Diversity
Documented equal pay policy
Dedicated Diversity/Inclusion Staff
Highly diverse management team
Unconscious bias training
Diversity manifesto
Diversity Employee Resource Groups
Hiring Practices that Promote Diversity
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
Company Equity
Child Care & Parental Leave Benefits
Generous Parental Leave
Flexible Work Schedule
Remote Work Program
Family Medical Leave
Vacation & Time Off Benefits
Generous PTO
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Relocation Assistance
Home Office Stipend for Remote Employees
Professional Development Benefits
Lunch and learns
Cross functional training encouraged
Promote from within
Customized development tracks
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