Compliance Specialist

Responsibilities

• Coordinate and monitor quality assurance activities to ensure and enhance the delivery of quality services, including monthly admission utilization reviews, quarterly ongoing utilization reviews, annual program operations reviews, client and staff satisfaction surveys, collection of program statistics, and tracking program outcome indicators
• Assist with auditing and monitoring activities related to compliance risk areas and ensure appropriate follow-up on audit findings
• Perform monthly audits of certified residential program billing documentation to ensure compliance prior to submission
• Support incident management processes to ensure compliance with regulatory requirements
• Conduct compliance investigations, prepare reports, make recommendations, and support corrective actions as assigned
• Aid in the development and annual review of agency policies, procedures, emergency plans, and other compliance-related documents
• Serve as backup System Administrator for the agency's electronic health record and other compliance/IT systems as needed
• Promote a culture of inclusion and belonging

Requirements

• Bachelor's degree preferred
• Relevant Quality Assurance and Compliance experience may be substituted for education
• Experience in Quality Assurance and Compliance within a Medicaid-funded program is preferred
• Candidates with experience in Medicaid service delivery and documentation in the human services field, along with strong written and verbal communication skills, are encouraged to apply
• Experience with electronic health records and other database systems is preferred
• Valid and insurable NYS driver's license required
• Must have your own vehicle to use for business purposes
• Ability to work collaboratively, maintain confidentiality, and support the agency's mission of delivering high-quality, compliant services