Compliance Auditor - YAI : Job Details

Implements the organization's compliance program under the supervision of the Assistant Director of Corporate Compliance and in coordination with program staff.

Maintains up to date knowledge of laws and regulations governing the documentation and billing of YAI services including, but not limited to State regulatory agencies (Office for People with Developmental Disabilities (OPWDD), Centers for Medicare and Medicaid Services (CMS), Office of Medicaid Inspector General (OMIG), Department of Health (DOH)), etc.

Develops monitoring tools and checklists for use in internal audits to assess compliance with applicable regulations and identify areas of concern in preparation for external audits.

Supports program leadership with oversight and ongoing monitoring of operations to ensure compliance with applicable regulations through conducting internal audits and reviews, working with programs to create, implement and monitor plans of corrective action.

Attends regional and/or departmental meetings to keep staff informed about audit findings and risks, new developments in compliance regulations and compliance related policies and/or to monitor for potential risks or concerns.

Serves as a resource for compliance and/or HIPAA issues, questions and concerns; gathers and effectively presents information in response to inquiries both from internal and external sources.

Completes timely and thorough investigations into compliance and HIPAA related incidents.

Performs general compliance audits of services delivered by programs.

Produces written reports of audits conducted, including findings, risks, recommendations, and corrective actions, as appropriate.

Participates in external audits of the agency as needed or as assigned.

Regularly collaborates with YAI support teams and operations to review/ensure compliance with relevant YAI, State and Federal requirements.

Attends relevant provider association meetings and external trainings, including Interagency Council and other committee meetings, to learn about changes in regulations, initiatives and issues in organizations supporting individuals with I/DD and broader issues/concerns related to the DD field.

Assists in the development and implementation of YAI Network compliance-related policies and procedures, including development of and updates to compliance training materials and facilitating trainings, as needed.

Regularly communicates with program and other staff to monitor program operations, changes and/or compliance-related activities and keeps the Assistant Director of Corporate Compliance informed of issues and overall compliance in the agency and appropriately escalates matters, as needed.

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 compliance, auditing and investigations, 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 to locations across the organization as needed.
• Working knowledge of Microsoft Office Suite required 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
• One (1) year of experience in the I/DD field, preferably in OPWDD certified residential setting or similar social services experience
• One (1) year experience monitoring compliance with and/or investigating HIPAA violations or concerns
• Knowledge of NYS OPWDD rules and regulations
• Valid driver's license

Schedule: Monday to Friday 9am to 5pm

Salary: $70,000.00

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.