R020258 Compliance and Quality Improvement Manager (CQIM) - Queens

YAI; New York (NY); On-site; USD 63,000 - 77,000; Full time

Job summary

YAI in New York City area is seeking a full-time Compliance and Risk Analyst to perform internal reviews, ensure regulatory documentation and billing integrity, and support OPWDD CMS compliance across sites in Queens and surrounding regions.

The role requires staying current on laws, strong communication, and regular travel. It offers growth within a mission-driven, person-centered services organization.

Qualifications

• Bachelor’s degree in human services, business, compliance, or related field and 3 years of experience in providing services, oversight, and support.
• Satisfactory 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 analytical skills.
• Ability to maintain confidentiality and security of sensitive information and files.
• Ability to travel regularly to locations across assigned region(s).
• Working knowledge of Microsoft Office Suite and ability to learn new software.

Responsibilities

• Completes formal internal reviews and risk assessments for YAI programs at least annually.
• Maintains up to date knowledge of laws and regulations governing documentation and billing.
• Provides on-site support during OPWDD DQI and OFPC surveys.
• Supports regional leadership with risk assessments and annual compliance planning.
• Participates in planning for new certified sites and programs with feedback from a quality perspective.
• Acts as liaison between program leadership and oversight staff.
• Assists in Plan of Corrective Action following deficiencies.
• Develops safety plans prior to construction in certified settings.
• Ensures services are person-centered and compliant with regulations.
• Guides on reportable incidents and HIPAA concerns.
• Monitors incidents in IRMA and assists with timely entry of information.
• Participates in agency committees and may chair.
• Attends monthly regional leadership meetings; reports on regulations and survey activity.
• Performs other duties as assigned.

Skills

Excellent written communication

Verbal communication

Interpersonal skills

Analytical thinking

Attention to detail

Time management

Team player

Education

Bachelor’s degree in human services, business, compliance, or related field

Master’s degree (preferred)

Tools

Microsoft Office Suite

Job description

This position requires traveling to various sites within Queens, NY area

Key/Essential Functions & Responsibilities

• Completes formal internal reviews and specialized risk assessments for YAI programs at least annually and provides feedback on the findings.
• Maintains up to date knowledge of all applicable laws and regulations governing the documentation and billing of YAI services including, but not limited to State regulatory agencies (OPWDD, Centers for Medicare and Medicaid Services (CMS), Office of Medicaid Inspector General (OMIG), Department of Health (DOH)), etc. and provides training as needed.
• Provides on-site support during targeted annual OPWDD DQI and OFPC surveys.
• Supports regional leadership with identifying compliance risks, completing an annual risk assessment, and developing an annual compliance plan for the region.
• Participates in planning meetings related to the development of new certified sites and programs throughout the organization to provide feedback from a person-centered, quality perspective and to ensure consideration of OPWDD DQI regulations.
• Acts as a liaison between program leadership and oversight entity/external agency staff, as needed.
• Assists program leadership with developing a Plan of Corrective Action in response to any formal Statement of Deficiencies received and completes appropriate follow-up visits to ensure implementation.
• Assists program leadership with developing safety plans prior to the initiation of any construction or repairs in certified settings that may impact the health and safety of people supported.
• Uses education and internal auditing to ensure that programs deliver individualized services, provide choices, and protect the rights of people supported while protecting their health and safety and adhering to all applicable regulations and documentation requirements.
• Provides guidance and support related to reportable incidents and occurrences as well as compliance and HIPAA concerns.
• Monitors incidents in IRMA and assists program staff with appropriate and timely entry of information.
• Participates in various agencywide committees, such as Incident Review, Human Rights, Informed Consent, and Policy Committees; may act as chairperson for committees, as requested or appropriate.
• Attends monthly regional leadership meetings and provides updates on regulations, risk areas, identified trends, and survey activities throughout the regions.
• 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 field and three (3) years of experience in providing services, oversight, and support, preferably in healthcare, social services and/or with the I/DD population; or
• Satisfactory 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.
• 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 regularly to locations across assigned region(s).
• Working knowledge of Microsoft Office Suite and ability to quickly learn new software and/or electronic systems.
• 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 field indicated above
• Certification in Healthcare Compliance (CHC) or related training/certification
• Experience completing audits and/or reviews of internal systems to ensure compliance with policies, procedures and regulations
• Knowledge of NYS OPWDD rules and regulations
• Advanced knowledge of IRMA
• Valid driver's license

Salary: 70,000.00 Annually

Schedule: Monday to Friday 9am to 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.

To ensure fairness, safeguard transparency, and promote an equitable workforce environment, YAI Network prohibits the practice of nepotism in the workforce and hiring process.