Director of Compliance & Medicaid Programs

Brooklyn Community Services; New York (NY); On-site; USD 125,000 - 155,000; Full time

Job summary

Brooklyn Community Services (BCS) in New York seeks a Director of Compliance to lead the design, implementation, and ongoing management of the organization’s compliance program, including Medicaid compliance, to prevent fraud, waste, and abuse. The role works with program and administrative leaders to strengthen processes, develop policies, and ensure regulatory adherence.

In this hands-on leadership position, you will build centralized calendars, risk-based work plans, and reporting frameworks,

Qualifications

• Bachelor’s degree in public administration, healthcare administration, human services, social work, business, finance, law, compliance, or related field.
• At least seven years of progressive, hands-on experience in compliance, auditing, regulatory affairs, quality assurance, risk management, public contracting, or related work; seven to ten years preferred.
• Direct experience with New York Medicaid compliance and human-services requirements.
• Experience building compliance systems where processes were incomplete, inconsistent, or absent.
• Hands-on experience writing policies and procedures, creating compliance tools, reviewing records, conducting file audits or site visits, delivering staff training, and verifying corrective actions.
• Experience assessing service documentation, billing support, program eligibility, or claims-related records and collaborating with Finance and program teams to resolve issues.

Responsibilities

• Develop, implement, and maintain a comprehensive Medicaid compliance program to prevent, detect, and address fraud, waste, and abuse in accordance with NYS requirements.
• Serve as BCS’s designated Medicaid compliance officer and lead the compliance committee required under 18 NYCRR Subpart 521-1.
• Ensure and strengthen confidentiality and privacy requirements, including HIPAA, 42 CFR Part 2, NYS Shield Law, OMH requirements, and NYC privacy laws.
• Develop written policies, standards of conduct, and procedures addressing compliance expectations, reporting, investigations, disciplinary standards, and non-retaliation.
• Design and conduct risk-based reviews of service documentation, billing support, eligibility, authorization, and other applicable Medicaid risk areas.
• Establish and verify exclusion-screening procedures, including OIG, OMIG, and SAM checks for staff, Board members, vendors, contractors.
• Coordinate required provider compliance attestations and maintain supporting evidence.
• Complete and document the annual compliance-program effectiveness review.
• Coordinate identified overpayment review, reporting, repayment, and corrective action with Finance and counsel.

Education

Bachelor’s degree in public administration, healthcare administration, human services, social work, business, finance, law, compliance, or related field

Certified in Healthcare Compliance (CHC) or Certified Compliance and Ethics Professional (CCEP)

Job description

Brooklyn Community Services (BCS) in New York seeks a Director of Compliance to lead the design, implementation, and ongoing management of the organization’s compliance program, including Medicaid compliance, to prevent fraud, waste, and abuse. The role works with program and administrative leaders to strengthen processes, develop policies, and ensure regulatory adherence.

In this hands-on leadership position, you will build centralized calendars, risk-based work plans, and reporting frameworks,