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Compliance Verification Specialist

Location: Hackensack, NJ
Compensation: $38,000 to $46,500 | Full-Time

Overview:

Who is Bergen’s Promise?

Bergen's Promise is the Care Management Organization (CMO) of Bergen County as part of the New Jersey Children's System of Care. We are a rapidly growing, mission driven, non-profit social service agency. We are accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF).

Bergen's Promise serves youth up to age 21 and their families. The youth we serve are experiencing serious behavioral, emotional, mental health, substance use challenges and/or developmental disabilities.

Our Wraparound Model of Care leverages the Child and Family Team to build on a family and community's unique strengths, values, and resources. This evidence informed Wraparound approach sets us apart from other social service agencies. We encourage you to explore our website to get more informed and a feel of who we are as an agency.

Top 5 reasons to join Bergen's Promise Team:

  1. You will make a significant difference in the life of a child.
  2. Professional and personal growth and development are important to you.
  3. You are adaptable and like being part of a supportive team of colleagues working in a fast paced environment.
  4. You want to work for a mission-driven organization whose Values align with your own.
  5. You understand the value of a comprehensive benefit package that supports you through all life stages.

Responsibilities:

• Serve as the primary auditor of youth and family charts and quality service delivery, including

• Review of family and youth charts to ensure the amount, timeliness and quality of service delivery is provided in accordance with contracted standards; skills include

  • Attention to detail
  • Efficient use of resources
  • Efficient time management
  • Strong organizational skills

• Communicate with families via phone, video and/or in-person to ensure the amount, timeliness and quality of service delivery is provided in accordance with contracted standards; skills include

  • A true interest in and enthusiasm for direct communication with the families we serve
  • Effective communication with families whose healthcare system knowledge may be limited
  • Assist with Medicaid application questions
  • Troubleshooting
  • Diplomacy
  • Ability to handle complaints
  • De-escalation

• Record details of family contacts and actions taken, if any

• Create and maintain reports and dashboards to inform management in decision-making and corrective action

• Maintain strict confidentiality of all of the forgoing, including information and processes

• Provide additional data reporting and analysis as needed

• Perform other duties as assigned

Qualifications & Skills:

• Bachelor’s Degree, preferably in finance, health, business administration or a related field

• Fluency in applicable office technology and software, including Microsoft 365 and its component parts

• Strong written and verbal communication

• Excellent interpersonal skills

• Experience in quality improvement, compliance, and/or insurance preferred

• A flexible schedule to accommodate communication with working families

• Bi-lingual English/Spanish preferred

Core Competencies:
• Conveys ideas and facts, both verbally and in writing, using language that others will best understand; listens with undivided attention while seeking to understand
• Makes decisions with knowledge of facts, goals, constraints, and risks within the scope of their position, including consideration of the health and safety of all stakeholders
• Is accountable to fiscal guidelines, regulations, principles, and standards when committing resources
• Develops solution-focused and creative ideas when problem solving and working to achieve goals
• Takes personal responsibility for the quality and timeliness of work, is resourceful and achieves results with little oversight
• Adapts to changing business needs, conditions, and work responsibilities
• Displays an on-going commitment to learning and professional development; responds positively to coaching and feedback
• Facilitates collaborative, professional, and productive relationships with all agency stakeholders
• Helps create a work environment that embraces and appreciates diversity
• Strong ability to work independently, manage multiple complex and high priority assignments

Benefits:

We offer an OUTSTANDING comprehensive benefit package including:

  • Medical, Dental, and Vision coverage
  • Generous time off including vacation, personal, sick time and 13 paid holidays each year.
  • Life Insurance, Long Term Disability Insurance and AD/D insurance fully paid for by Agency
  • Employer funded pension plan
  • Flexible Spending Account
  • AFLAC supplemental plans available
  • Long Term Care plan available
  • Credit Union member
  • Plum Benefits – discount tickets to concerts, theater, sporting events
  • 15% discount on Verizon Land/Cell phone plans.
  • Professional Development Opportunities

Bergen’s Promise is an equal opportunity employer. We honor diversity and are committed to creating a culture that embraces all.


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