Compliance Specialist - Human Services

When you work for Gateway Hudson Valley, you make a difference in people's lives.

Our Vision: To be a leader in supporting individuals as they strive to achieve a hopeful, satisfying, active, and contributing life.

We offer Medical, Dental, Life Insurance, 403(b) Retirement, Holidays, and generous PTO

POSITION SUMMARY: The Compliance Specialist works with the Chief Quality and Compliance Officer to develop, implement and maintain quality assurance and compliance processes to ensure the delivery of high-quality services. This role involves meticulous monitoring, evaluation, and enhancement of service delivery standards, ensuring compliance with all relevant regulations and improvement, facilitating training, and supporting the overall mission of the agency.

RESPONSIBILITIES:

Auditing: Conduct monthly Medicaid and/or other quality audits to ensure the Agency meets the standards for program compliance and Medicaid billing requirements.

Investigation: Assist CQCO in investigating all internal incidents including; tracking incidents, conducting interviews, reporting in databases (IRMA/NIMRS), writing reports and developing and following up on corrective action plans.

Training and Support: Assist CQCO in the development of training materials and operating manuals and provide training and support to program staff to ensure understanding and adherence to quality standards.

Electronic Health Record (EHR): Provide staff tech and administrative support in use of EHR, problem solving, report management and form building.

IRC Committee: Compile monthly Incident Review Meeting agenda and minutes, distribute minutes and agenda, attend monthly meeting and take minutes

BQCAC Committee: Attend semi-annual Board Quality, Compliance and Audit Committee meeting, complete minutes and distribute to committee members

Continuing Education: Pursue ongoing education and training to stay current with new laws, rules, and regulations affecting quality assurance and service delivery.

Documentation and Reporting: Document all quality assurance activities and create detailed audit reports to track progress and identify areas for improvement.

Recommendations for Improvement: Make informed recommendations for service and process improvements based on data analysis and quality assurance findings.

Participant and Patient Surveys: Administer or assist CQCO with administration of surveys, analyze annual participant satisfaction and Patient Characteristic Surveys to gather feedback and identify areas for service improvement.

Data Collection and Analysis: Collect and analyze statistical data related to referrals, program utilization, and participant demographics to inform program development and quality improvement initiatives.

Compliance Maintenance: Ensure compliance with all federal, state, local, and organizational laws, regulations, guidelines and policies.

Core Values: While carrying out the responsibilities of this position, the Quality Assurance Assistant will embrace the mission, vision, values, and philosophies of the agency.

Other:

Prepare and send out monthly and annual vendor letters

Monitor Compliance Hotline and Anonymous Compliance Box for messages

Compile quarterly OMH stats for Compliance Officer

Other miscellaneous tasks requested

AGENCY STANDARDS

Demonstrate positive work attitudes and habits.

Works cooperatively with agency staff to assure that the mission, vision and values of Gateway are met.

Maintain a clean and neat appearance

Attend all required meetings and trainings.

Participate in training programs for professional growth as scheduled and approved.

Responsible for understanding and adhering to Gateway Hudson Valley's Corporate Compliance Policy and Standards of Conduct as well as all applicable program rules, regulations and policies. Keep abreast of any changes or modifications to policies or regulations. Ensure that all staff are knowledgeable of applicable regulations, laws, and policies.

Perform other duties as assigned.

EQUIRED QUALIFICATIONS

Education:

Bachelor's degree in a related field preferred; or

Associate degree and 1+ years of experience in compliance and QA; or

High School Diploma and at least 3 years' experience in compliance and QA.

Experience:

Prior experience in Human Services; and

Prior experience is quality assurance and compliance preferred

WORKING CONDITIONS

Must be able to lift up to 15lbs

Must be able to stand, walk, stoop and bend

Must be able to sit or stand for 8 hours per day

REGULATORY CLEARANCES REQUIRED:

Must have a favorable result from all state, federal, and agency mandated background checks

New York State Justice Center Fingerprinting Criminal Background Check

Statewide Central Registry Check

We are an EEO/AA employer M/F/D/V/SO employer