Compliance Specialist, Quality Assurance - QA​/QC

SUS is seeking a Compliance Specialist within their QA department.

This position is located at 7th Avenue New York, NY 10018.

SCOPE OF ROLE
:

The Support Services functions at S:

US are carried out by a team of professionals with differing

backgrounds who share deeply in the S:

US mission. We provide resources and support to the

program departments to collectively pursue that mission. Support Services is a collegial, supportive and dynamic culture that continuously seeks to improve. We strive to treat all staff with respect in each interaction. We are motivated to accomplish our individual and collective tasks by the belief that we can help transform the lives of people we serve thereby righting societal imbalances.

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

KEY RESPONSIBILITIES:

Communication: Ability to communicate effectively and demonstrate good interpersonal and professional skills when interacting with individuals served, co-workers, and management. Maintain open communication with your supervisor as it relates to the completion and accuracy of assignments. Listen and respond appropriately to others’ ideas, make suggestions and offer alternative solutions, and give and receive honest, constructive feedback.

Quality of Work: Assignments are accurate, complete, timely, and comply with agency and department policies and procedures. Independently work towards overcoming challenges and barriers to accomplish performance objectives. Complete an acceptable quantity of work within deadlines, while maintaining the required quality and accuracy of the work.

Integrity/Compliance: Uphold personal and…