The role of the Compliance Specialist is to ensure all programs and processes are aligned with all regulatory requirements.
Specific Knowledge, Skills, and Abilities:
- Ability to effectively communicate verbally and in a written manner
- Microsoft Office experience
- Self-starter with ability to complete objectives quickly
- Ability to organize, schedule, prioritize and utilize time effectively
- Excellent interpersonal skills, confidentiality and professionalism
- Must be detail oriented, efficient, and organized.
- Ability to multitask and meet tight deadlines
Required Experience
- Minimum 2 years in a Quality Assurance role
- OPWDD, CMS, and DOH knowledge
- Provide SSP/Data Security Support
- Handle all SSP related reporting/triage, including Quarterly Names List & User access reports Lists
- Conduct weekly test calls and prepare the weekly phone report. Perform other activities, as assigned, to support overall organization’s goals and objectives
Essential Responsibilities:
- Keep informed of all modified and existing codes, rules, regulations, respond to requests from government agencies and meet with government officials when needed.
- Support PCR and NCI coordination with outside entities
- Communication with state reviewers
- Conducting internal audits/reviews, including Medicaid Standards Reviews
- Assist the Chief Compliance Officer with responses to regulatory requests, subpoenas, and other document inquiries, ensuring accuracy and timely submission.
- Gathering data on non-compliance trends
- Familiarity with NYS OPWDD and NYSDOH regulations and implementation of policies and procedures
- Familiarity with Medicaid and OMIG requirements
- Manage all external audits – involved in all aspects of potential OMIG audits.
- Assist with regulatory and compliance-related research Identify, replicate, analyze and manage deviations in all aspects of the quality assurance function; especially as it relates to conducting and hosting audits
- Participate in mandatory staff meetings.
- Handle all compliance breaches, investigations, and compliance reports
- Conduct Service Confirmation Calls
- Provide SSP/Data Security Support
- Handle all SSP related reporting/triage, including Quarterly Names List & User access reports Lists
- Conduct weekly test calls and prepare the weekly phone report. Perform other activities, as assigned, to support overall organization’s goals and objectives
