Quality Improvement & Compliance Specialist (Medicaid/HCBS)

Program Development Services, Inc.; New York (NY); On-site; USD 70,000 - 100,000; Full time

Job summary

NeuSpark PDS is seeking a detail‑oriented Quality Improvement and Compliance Specialist to support adherence to OPWDD regulations, Medicaid standards, and internal policies. This role monitors quality indicators, conducts audits, and reports findings to program leadership to drive corrective actions across all programs.

The ideal candidate has auditing and analytical skills, with 2+ years in human services or healthcare compliance, proficiency with Microsoft 365, data systems, and Medicaid

Qualifications

• Bachelor’s degree in Human Services, Healthcare Administration, or related field (or equivalent experience).
• 2+ years of experience in compliance, quality assurance, or program evaluation.
• Knowledge of OPWDD regulations, Medicaid billing compliance, and HCBS standards.
• Strong organizational, analytical, and communication skills.
• Proficiency in Microsoft 365 (SharePoint; Fabric, PowerBi), external reporting systems (WSIR, IRMA, CHOICES, NIMIRS), and data analysis tools; experience with EHR systems highly preferred.

Responsibilities

• Ensure compliance with Federal and State regulations via site visits and documentation review.
• Investigate reportable incidents within regulatory timeframes.
• Conduct regular site visits to verify maintenance and standards.
• Review program records for staff trainings and in‑service requirements.
• Communicate findings to program staff and leadership with clear documentation.
• Deliver trainings on regulatory requirements to staff.
• Collaborate with billing teams to ensure Medicaid documentation accuracy and compliance.
• Maintain confidentiality at all times.

Skills

Auditing

Compliance

Data analysis

Communication

Training delivery

Organization

Education

Bachelor's degree in Human Services

Tools

Microsoft 365

SharePoint

Power BI

WSIR

IRMA

CHOICES

NIMIRS

EHR systems

Job description

NeuSpark PDS is seeking a detail‑oriented Quality Improvement and Compliance Specialist to support adherence to OPWDD regulations, Medicaid standards, and internal policies. This role monitors quality indicators, conducts audits, and reports findings to program leadership to drive corrective actions across all programs.

The ideal candidate has auditing and analytical skills, with 2+ years in human services or healthcare compliance, proficiency with Microsoft 365, data systems, and Medicaid