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Compliance Specialist

4 months ago

Utica, United States ICAN Full time
Job DescriptionJob DescriptionThe Compliance Specialist is responsible for ensuring that the organization adheres to all relevant laws, regulation, and industry standards related to compliance. Their primary role is to develop, implement, maintain an effective compliance program to minimize legal and regulatory risks. This position will involve developing, implementing, and managing the organization's compliance program to safeguard our patients, employees, and reputation. The Compliance Specialist will promote the philosophy and mission of the agency by performing the following duties.

Duties and Responsibilities:

  • Regulatory Compliance: The Compliance Specialist keeps updated of all relevant federal, state, and local laws, regulations, and guidelines related to behavioral health. They ensure that the organization's practices, policies, and procedures align with these requirements and recommend necessary changes or updates when needed.
  • Risk Assessment and Mitigation: The Compliance Specialist conducts regular risk assessments to identify potential compliance vulnerabilities and areas of improvement. They develop and implement strategies to mitigate risks and ensure ongoing compliance.
  • Audits and Monitoring: The Compliance Specialist performs internal audits and monitoring activities to assess the organization's compliance with incidents, policies, and procedures. They identify compliance gaps or issues and work with relevant departments to address them effectively.
  • Training and Education: The Compliance Specialist develops and delivers training programs to educate employees on compliance-related matters. They ensure that employees are aware of their responsibilities and understand the organization's compliance policies and procedures.
  • Investigations and Reporting: In cases of suspected violations, the Compliance Specialist conducts duties to gather evidence and help the Compliance Manager and Compliance Officer determine the extent of non-compliance.
  • Policy and Procedure Development: The Compliance Specialist collaborates with cross-functional teams to develop and update policies and procedures that comply with relevant regulations. They ensure that these documents are accessible to employees and regularly reviewed for effectiveness.
  • Compliance Monitoring and Reporting: The Compliance Specialist establishes mechanisms to monitor ongoing compliance activities within the organization. They develop and distribute regular reports to management and relevant stakeholders, highlighting compliance performance and recommending corrective actions if necessary.
  • Continuous Improvement: The Compliance Specialist stays informed about emerging trends, best practices, and changes in laws and regulations related to behavioral health compliance. They actively seek opportunities to enhance the organization's compliance program and processes.
  • Create compliance resource library with the Compliance Manager for staff members to reference when they have questions
  • Additional duties may be assigned on an as needed basis.


Education / Experience:

  • Bachelor’s Degree and 1+ years experience in risk management and/or compliance roles and have, or be willing to obtain, a compliance certification.
  • Familiarity with protocols of the Office of the Medicaid Inspector General (OMIG) and risk management protocols along with experience and strong knowledge of health care/non-profit protocols and best practices preferred.
  • Experience with documenting incident reports within the behavioral health field and the ability to assist the Compliance Officer with investigations that may result from deficient documentation or possible fraud.
  • Valid NYS Drivers License is required.