SPECIALIST (INCIDENTS & INVESTIGATIONS)-PCM DEPARTMENT

Duties & Responsibilities

• Conduct investigations related to incidents, complaints, and regulatory concerns across programs, as assigned
• Develop investigative plans; identify relevant witnesses, records, policies, regulatory requirements, and other evidence necessary to address each allegation or concern
• Perform interviews, collect statements, and review documentation to ensure thorough and objective investigations
• Analyze testimonial, documentary, electronic, and physical evidence to reach objective, evidence-supported findings and identify any immediate safety, compliance, or operational concerns requiring escalation
• Prepare clear, comprehensive investigative reports with findings and recommendations
• Ensure investigations are completed in a timely manner and in compliance with all applicable regulatory standards, including but not limited to the NYS Justice Center, OPWDD, OMH, ACS, DOH, OCFS, NYSED, and other relevant Federal, State, and local oversight entities
• Track and monitor incident data and follow-up actions
• Audit, evaluation & quality monitoring:
  • Conduct program audits, compliance reviews, performance evaluations, and case record reviews across assigned programs
  • Monitor program performance indicators, regulatory requirements, and compliance metrics
  • Identify compliance gaps, trends, and opportunities to strengthen internal controls while providing actionable recommendations
  • Support the development, implementation, monitoring, and follow-up of corrective action plans
  • Participate in internal and external audits, including PAMS, VARs, surveys, site visits, and other regulatory reviews as assigned
• Data, Reporting & Trend Analysis:
  • Collect, analyze, and interpret data related to incidents, audits, and program performance
  • Develop and maintain tracking systems, logs, and databases
  • Generate recurring and ad hoc reports regarding audit findings, compliance trends, regulatory performance, corrective actions, and organizational risk
  • Identify patterns and emerging risks and provide recommendations for mitigation
  • Support leadership with data-driven insights for decision-making
• Training, Collaboration & Support:
  • Provide technical assistance and support to program leadership and staff regarding compliance requirements, investigations, audits, corrective actions, and quality-improvement initiatives
  • Conduct staff training on incident management, regulatory requirements, investigative processes, and audit findings
  • Participate in new-hire training, as needed, to provide instruction on incident reporting requirements, investigative processes, staff responsibilities, and cooperation with agency investigations
  • Contribute to internal committees, meetings, and quality-improvement initiatives
  • Collaborate with cross-functional teams to promote alignment with regulatory requirements and agency compliance standards
• Flexibility & Operational Support:
  • Adjust workload and priorities based on agency priorities, departmental needs, regulatory changes, and emerging issues
  • Provide cross-functional collaboration and support based on operational needs and departmental priorities
  • Perform other duties and responsibilities as assigned

Education & Experience

• Bachelor’s degree in Social Work, Psychology, Public Administration, Healthcare, or a related field required; equivalent combination of education and relevant professional experience may be considered in lieu of the degree
• Minimum of 1–3 years of experience in compliance, investigations, quality improvement, auditing, or related field preferred
• Experience working within regulated environments (NYS Justice Center, OPWDD, OMH, ACS, DOH, OCFS, NYSED, and other relevant Federal, State, and local oversight entities) strongly preferred

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer
• Ability to lift up to 25 pounds if needed
• Required to commute to other agency locations as needed