What are the responsibilities and job description for the Compliance Generalist position at Behavioral Health Services North Inc?
A Spanish version of this position is available upon request
La version de esta posicion esta disponible en Español si es requerida
The Compliance Generalist performs critical functions to help ensure that BHSN complies with regulatory standards in programs across the organization. This detail-oriented individual works closely with the Compliance Officer to coordinate the reporting, tracking, investigation and follow up on incidents, and executing other departmental duties related to the operations of an effective Quality and Compliance Department.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Assists the Compliance Officer in logging, reviewing and documenting reportable incidents and conducting formal investigations;
- Assists the Ombudsman, hearing complaints or grievances and conducting formal investigations as necessary;
- Reports violations, including breaches, whether potential or actual, as required;
- Monitors implementation/effectiveness of Program Improvement Plans or other corrective action plans;
- Participates in record audits including, but not limited to, the state agency regulatory recertification, grant compliance and/or health plan audits; performing duties such as preparing requested documents, securely sharing documentation, and corresponding with auditors/reviewers;
- Ensures timely and accurate completion and proper filing of all documentation associated with audits, calls or other correspondence to the Compliance Hotline and their resolution, investigations, self-disclosures operating certificates, training records and distributions of policies/procedures;
- Assists in the Utilization Review (UR) and Self-Disclosure processes and related activities necessary to continually improve programmatic and overall agency compliance with applicable regulations;
- Gathers information regarding payer reimbursement as part of follow-up on pre and/or post-billing compliance, Utilization Reviews, and/or compliance investigations as directed;
- Provides data and reports as directed or requested regarding compliance-related activities;
- Corresponds with personnel from OMH, OASAS, DOH, OCFS, and/or the Justice Center as necessary to clarify expectations with regards to compliance issues;
- Participates in internal audit activities to assess Agency program regulatory compliance;
- Identifies and communicates potential areas of compliance vulnerability and risk;
- Assists in gathering and reporting data across OMH programs for the Patient Characteristics Survey;
- Maintains and protects client confidentiality and Protected Health Information across the agency through policy, training, and risk-management;
- Attends agency and Departmental meetings, including but not limited to, Incident Review Committee and Departmental staff meetings;
- Supports critical compliance activities as directed;
- Required to actively seek out and maintain knowledge regarding Federal and State agency regulations.
SKILLS AND QUALIFICATIONS
- Demonstrated professional experience in compliance strongly preferred
- Associate’s degree in related field required; Bachelor’s degree preferred
- Proficiency in Microsoft Word and Excel required
- Strong organizational, interpersonal, and communication skills required
- Must be able to maintain strict confidentiality
- Detail-oriented
- Ability to work with a diverse group of people required
- Valid NYS driver’s license and reliable transportation required for regional travel
EEO Statement: BHSN is an Equal Opportunity Employer, and supports Diversity, Equity, and Inclusion in its hiring and employment practices so that every team member can feel like they belong and be their authentic self to thrive in their personal and professional lives. In order to do that, all applicants will receive consideration for employment without regard to age, race (including traits historically associated with race, including but not limited to, hair texture and protective hairstyles), creed, color, national origin, sexual orientation, military status, sex, disability, genetic predisposition or carrier status, marital status, arrest record or status as a victim of domestic violence, familial status, gender/gender expression, reproductive health decisions, citizenship or immigration status or any other factor prohibited by law.
