If you are a current YAI employee, please click this link to apply through your Workday account.

Key/Essential Functions & Responsibilities

Monitors the compliance program and updates the compliance plan as needed in response to requirements set forth in laws, regulations, government entities, and payers as well as to changes within the industry and the organization.Designs and implements auditing and monitoring activities in accordance with the agency’s compliance plan in collaboration with Director of Compliance and Quality Improvement and directs team members engaged in these functions. Interfaces with and maintains a professional relationship with external entities and oversight agencies such as the Office for People with Developmental Disabilities, New York State Department of Health, and the Office of Medicaid Inspector GeneralDirects corporate compliance team members in investigating compliance related matters including, but not limited to, falsification of records, billing errors and privacy breaches.Makes recommendations based on investigations and audits for follow up including, but not limited to the completion of voids and submission of self-disclosures to OMIG and identifies systems to prevent reoccurrences.Supports agency departments and affiliates during external audits and responds to government inquiries, audits and requests; appropriately escalates concerns and issues to director for guidance or assistance.Co-chairs the agency Compliance Committee and Policy Review Committee with the Chief Quality, Compliance and Ethics Officer, developing agendas, collecting, organizing, and presenting data, facilitating discussions and soliciting information, as applicable.   Ensures the timely review, revision and distribution of agencywide policies in accordance with applicable schedules through regular monitoring, coordinating with content experts and securing necessary approvals for updates. Tracks, compiles and analyzes data and creates various reports on trends in compliance investigations, billing errors, self-disclosures, or other noteworthy concerns for distribution at regular intervals.Produces quarterly and annual trend analysis on compliance audit findings, hotline calls and compliance investigations.   Stays abreast of regulatory changes through attendance at trainings and provider association meetings and review of guidance documents and trade publications and acts as a resource to agency personnel and affiliates.Develops or assists in the development of educational material relevant to compliance and HIPAA and facilitates trainings, as appropriate.Assists Chief Quality, Compliance & Ethics Officer in preparing compliance reports to the board of YAI and affiliate agencies.Ensures that excluded individuals and entities are not employed or retained by the organization in coordination with HR and Finance.Oversees the agency’s risk assessment process, ensuring timely distribution, receipt and compilation of annual risk assessment data and monitors progress on identified objectives.Maintains a system for receiving reports and responding to concerns, complaints, and questions related to compliance and HIPAA.Ensures that independent contractors (patient care, vendors, billing services, etc.) are aware of the requirements of the agency’s compliance plan.Performs all other duties, as assigned.

Minimum Qualification Requirements including education, experience, licensure/certification, etc. and essential physical capabilities (e.g. lifting, assisting lifting, standing, etc.)

Bachelor’s degree in human services, business, compliance, or a related area of study and five (5) years of experience in compliance, auditing and investigations in healthcare, social services and/or with the I/DD population; orSatisfactory equivalent combination of education, training and/or experience.Excellent written and verbal communication and interpersonal skills.Strong commitment and passion for the organization’s mission.Unquestionable ethics and integrity, high emotional intelligence and well-developed independent thinking and analytical skills, with commitment to objectivity.Demonstrated knowledge of applicable federal, local, and state regulations.Ability to identify and respond to areas of concern and work successfully with senior leadership in a collaborative environment.Ability to maintain confidentiality and security of sensitive information and files.Ability to work well independently and in a team environment, and to manage one’s time effectively.Ability to travel to locations across the organization as needed.Strong attention to detail and organizational skills, with ability to work well under pressure and prioritize to meet tight deadlines.

Preferred Qualification Requirements (desired requirements beyond MQRs above)

Master’s degree in any area indicated aboveTwo (2) years of experience in a leadership position, including direct supervision of staff across various work locationsCertification in Healthcare Compliance (CHC) or related training/certificationValid driver’s license

Compensation:

$80,000.00 annually

Schedule - Monday to Friday 9am-5pm

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or status as a Vietnam or disabled veteran. YAI is an Equal Opportunity Employer.