Bachelor's degree in Health Sciences or Human Services; Master's preferred.
3+ years of experience in health services compliance, particularly with 29I and Health Homes.
1-3 years of experience working with children, youth, and families in health services.
Strong skills in oral and written communication, program evaluation, and project management.
Compliance with extensive background checks and mandated reporter training.
Responsibilities
Provide compliance and data support for various health services programs.
Conduct thorough case and chart record reviews across all programs.
Analyze performance data and summarize findings for compliance meetings.
Prepare detailed reports for monthly and quarterly oversight committees.
Conduct regular compliance reviews and audits for multiple health services programs.
Assist in drafting corrective action plans based on audit findings.
Collaborate with staff to enhance the quality of healthcare services through data analysis.
Benefits
Four weeks' vacation.
Comprehensive medical, dental, vision, life, and disability insurance.
401(k) plan with a 7% employer contribution and 2% match.
Tax-deferred plans for healthcare, dependent care, and commuting expenses.
Flexible work schedule.
Opportunities for educational scholarships.
Full Job Description
Job Summary
The Compliance Manager Health Services Department will perform routine audits of all health services programs, ensuring that all regulatory mandates are met as well as identifying areas of improvement, trends, and performance.
Major Responsibilities/Activities
Provide compliance and data support to Health Services, including Article 29-I, Health Homes, and Children's Health and Behavioral Health Services Transformation (CFTSS)
Conduct case and chart record reviews for all programs.
Analyze data, records, and reports to monitor performance. Summarize findings for each program.
Prepare reports for monthly compliance check-in meetings and quarterly Quality Oversight Committee.
Conduct standing Compliance reviews including:
29I new foster care placement review
Biannual medication monitoring audits
Quarterly Medical Audits
Health Homes Quarterly audits
CFTSS Quarterly Audits
Follow up with NYS OCFS Quarterly Health Assessment audits
Assist in preparing for the ACS medical audit and responding support the team in drafting responses to any corrective action plans.
Draft corrective action plans from findings of internal audits completed and review progress at quarterly meetings.
Assist in the client satisfaction initiatives undertaken within the program.
Use ACS and OCFS reports to track regulatory performance.
Conduct focused reviews as requested by program.
Collaborate with other staff to analyze and report the results of QI work to improve the quality of healthcare services provided to clients.
Monitor and track incidents reported Health Homes Incident Reporting Management System and CFTSS New York State Incident Management and Reporting System (NIMRS)
Follow up with medical and behavioral health requests related to NYC ACS Office of Special Investigations
Assists in preparing for any accreditation audit health services should undertake.
Use PSYCKES to address health measures such as children on antipsychotic medications, ER visits, and others.
Maintain monthly dashboards of KPIs using Power Bi and refine the metrics to include policy updates/changes by regulatory oversight bodies.
Other duties as assigned.
Minimum Requirements
Bachelor's with a minimum of three years experience required, Master's preferred, in the area of Health Sciences or Human Services.
Experience with 29I and Health Homes audits and regulatory compliance strongly preferred
1-3 years' experience working in the area of health services provision to children, youth and families.
Skills and competencies including, but not limited to, oral and written communication, program evaluation, analytic and research methods, and project management.
Compliance with:
Required background checks, including: NYS Statewide Central Register of Child Abuse/Maltreatment, NYS Sex Offender Registry, NYS Division of Criminal Justice Services fingerprinting, NYS Justice Center Staff Exclusion List, NYS OMIG Medicaid Exclusion List.
Mandated reporter training.
Applicable provisions of the NYS Education Law with respect to hiring and retaining licensed professionals.
Salary: $80,000 - $90,000
Location: 67-35 112th Street Forest Hills, NY 11375
Benefits:Join the Forestdale Team and Enjoy Excellent Benefits:
Four weeks' vacation
Medical/dental/vision/life/disability insurance
401(k), 7% employer contribution + 2% match
Tax-deferred health care/dependent care/commuter plans
