Licensed Master Social Worker

MedReview is a leading provider of payment integrity solutions that help national and regional health plans promote population health, ensure payment accuracy, reduce administrative waste, improve provider relationships, and optimize financial performance. For more than four decades, MedReview has partnered with health plans, third-party administrators, and other healthcare organizations to deliver technology-enabled solutions that identify savings opportunities, drive operational efficiency, and improve healthcare outcomes.

MedReview is seeking a Licensed Master Social Worker (LMSW) to support the oversight and regulatory compliance of Licensed Home Care Services Agencies (LHCSAs) throughout New York City. This role is responsible for conducting policy and procedure manual reviews, pre-opening licensure activities, re-licensure surveys, operational compliance assessments, and related regulatory functions in accordance with New York State Department of Health requirements.

The ideal candidate will have strong knowledge of home care operations, regulatory compliance, and healthcare survey processes. This position requires excellent attention to detail, strong written communication skills, and the ability to work independently in both office and field-based environments.

• Review and evaluate policy and procedure manuals to ensure compliance with Article 36 and New York State Department of Health regulations.
• Identify deficiencies and communicate required revisions to applicants and agencies.
• Review application materials and supporting documentation for licensure and certification requirements.
• Make recommendations regarding licensure approval, denial, withdrawal, or corrective action based on regulatory findings.
• Conduct follow-up activities to ensure timely submission of required materials and corrections.

• Coordinate and participate in pre-opening reviews, conference calls, documentation assessments, and on-site surveys.
• Evaluate agency readiness, including personnel files, operational processes, environmental space, equipment, and policy implementation.
• Assess staff knowledge of agency policies and regulatory requirements.
• Prepare licensure recommendations and related correspondence for agencies and regulatory authorities.

• Conduct on-site operational surveys of Licensed Home Care Services Agencies (LHCSAs).
• Review client records, personnel files, quality improvement documentation, governing authority meeting minutes, complaint logs, admission materials, and other required records.
• Identify regulatory deficiencies and prepare Statements of Deficiency (SODs) utilizing state-approved systems and reporting tools.
• Document findings accurately and ensure all survey activities meet established regulatory standards.

• Prepare detailed reports, findings, recommendations, and regulatory correspondence.
• Maintain accurate documentation and tracking of survey activities, corrective actions, and agency communications.
• Review survey assessment reports and collaborate with leadership on regulatory questions and concerns.
• Monitor deadlines and maintain organized records of all assigned projects and surveys.

• Partner with internal reviewers, leadership, and regulatory stakeholders to support survey and compliance objectives.
• Contribute to continuous improvement initiatives and process enhancements.
• Participate in special projects and additional responsibilities as assigned.
• Promote a collaborative, professional, and team-oriented work environment.

• Master's Degree in Social Work.
• Current New York State LMSW or LCSW license in good standing.
• Experience in home care, healthcare operations, regulatory compliance, or a related healthcare setting.
• Strong written and verbal communication skills.
• Excellent organizational, analytical, and critical thinking abilities.
• Ability to interpret and apply healthcare regulations and compliance standards.
• Proficiency with Microsoft Office Suite, including Word and Excel.
• Ability and willingness to travel extensively throughout New York City and other assigned regions as needed.

• Two or more years of social work experience.
• Experience conducting audits, surveys, compliance reviews, or quality improvement activities.
• Familiarity with New York State Department of Health regulations and Article 36 requirements.
• Experience working with Licensed Home Care Services Agencies (LHCSAs).
• Experience preparing regulatory findings, corrective action plans, or compliance-related reports.

Within the first 12 to 24 months, this individual will:

• Conduct timely and thorough pre-opening and re-licensure surveys.
• Ensure policy and procedure reviews consistently meet regulatory standards.
• Deliver accurate and well-documented compliance findings and recommendations.
• Build strong working relationships with agencies, regulatory partners, and internal stakeholders.
• Maintain high levels of quality, accuracy, and responsiveness throughout the survey process.
• Contribute to operational excellence and continuous improvement initiatives within the LHCSA program.