As a Compliance Specialist, you will be joining a dynamic department that protects the organization as well as the people we serve. Specifically, your role will be to implement and develop regulatory compliance strategies, provide technical support to program staff (including trainings), and conduct targeted reviews, internal audits, and compliance investigations. The Compliance Specialist is responsible for preparing written reports summarizing review findings, reporting such findings to the Vice President of Quality Assurance and the Chief Corporate Compliance officer, and making recommendations for improvement and correction where identified. 

ESSENTIAL DUTIES & RESPONSIBILITIES:

Audits/Reviews

• Conduct Medicaid billing reviews to ensure documentation exists to support billing
• Review and audit the quality of clinical case documentation and services
• Conduct site visits to ensure compliance with all regulatory mandates
• Conduct follow up audits to confirm corrective actions have been implemented and are effective
• Draft written reports summarizing findings of various audits/reviews
• Help to develop audit tools to be used in various audits/reviews

Trainings

• Conduct compliance/documentation trainings for staff
• Help to develop and update training materials for compliance/documentation trainings

Compliance Investigations

• Conduct investigations regarding regulatory and compliance issues
• Draft investigation reports summarizing findings and recommending corrective actions

Compliance Support

• Provide technical assistance to staff when questions arise regarding documentation requirements or other compliance related issues
• Develop, review, analyze and improve internal controls and monitoring systems for various programs/departments
• Identify compliance risk areas and assist with the development and implementation of policies and corrective action plans where indicated
• Attend inter-departmental meetings representing the quality assurance department to ensure compliance with regulatory mandates
• Attend external meetings and trainings representing the agency at various trade associations
• Perform other duties as required.

Bachelor’s Degree required in related field, together with minimum of two (2) years of experience in the healthcare or non-profit field.

Must be willing to:

• Travel extensively in all of the boroughs
• Work a flexible schedule in order to meet the needs of the department.

PREFERRED QUALIFICATIONS & SKILLS

• Master’s Degree preferred.
• Audit experience preferred.
• In lieu of Bachelor’s Degree, High School Diploma or equivalent with minimum of seven (7) years of experience in the healthcare or non-profit field.

Join a team of employees who cares about the wellbeing of others.  We believe in fostering a culture built on our core values:  respect, integrity, support, maximizing individual potential and continuous quality improvement. 

S:US is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. S:US is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities, including allowance of the use of services animals. To request reasonable accommodation or if you believe such a request was improperly handled or denied, contact the Director of Recruitment at 646-565-5894.