Essential Job Functions:

• Manage the established Compliance Program and Compliance Plans for designated business units. Monitor the performance and effectiveness of the Compliance Program.
• Provide training on the Compliance Program and associated policies.
• Conduct compliance fraud, waste, and abuse investigations and reviews.
• Respond to alleged violations of rules, regulations, policies, procedures, and Standards of Conduct by evaluating, recommending the initiation of investigative procedures as assigned. Conduct/oversee investigation as assigned.
• Provide subject matter expertise on regulatory compliance and quality strategies.
• Initiate process for identification and communication of regulatory changes affecting areas of operation and programs.
• Identify potential areas of compliance vulnerability and risk; develop/implement plans for mitigation.
• Demonstrate and encourages the use of quality management theories, concepts and tools, and best practices into all work performed by self, direct reports, and agency staff as appropriate.
• Design, implement, and track the success of compliance and quality management programs driven by statistics and analytics that ensure operations can meet high quality standards to its clients.
• Communicate an overall vision for quality within the business units. Set goals and recommend organizational changes to achieve goals.
• Provide reports on a regular basis, and as requested, to keep Executive Management informed of the operations and progress of compliance and quality efforts.
• Act as HIPAA Privacy Liaison for designated affiliates. Conduct HIPAA Privacy incident investigations/analysis.
• Develop, maintain, train, and revise policies and procedures for HIPAA Privacy in accordance with federal law and state regulations.
• Provide direct oversight and supervision to Compliance/Quality Improvement Directors and Associate Directors as assigned.
• Manage CDSLT Policy and Procedure.
• Attend and serve on committees as assigned, including Compliance, Quality Management Oversight Committee, CDSLT Policy and Procedure Committee.
• Perform all other necessary duties relevant to the position as requested by the supervisor.

• Proficient in the use of all Microsoft applications (excel, work, power point, Microsoft outlook and access).
• Ability to work independently under minimal supervision.
• Ability to communicate effectively, both orally and in writing.
• Ability to be efficient and productive in a fast-paced environment.
• Detailed orientated and can multi-task.

• Bachelor’s degree required, Master’s degree is preferred.
• Healthcare Compliance Certification - CCEP, CHC, and/or CHPC is preferred.
• 7 years’ management experience in the field of healthcare regulatory compliance and quality improvement to include demonstrated leadership. Knowledge of Office of People with Developmental Disabilities (OPWDD) and/or NYS Department of Health (DOH) regulation is preferred.
• Familiarity with operational, financial, quality assurance, quality improvement, and human resource processes and regulations desired.