Behavioral Health Regulatory Compliance Specialist

Upstate Cerebral Palsy•City of Utica, NY

11d•$29 - $34•Hybrid

About The Position

We are hiring a Compliance Review Specialist to join our growing team! This position will be responsible to develop recommendations based upon review findings, develop review protocols, conduct risk assessments and prepare reports. Standard schedule is 8 am - 4 pm Monday - Friday, but there is some flexibility available to meet candidate needs.

Requirements

Strong attention to detail.
Demonstrated skill in written and verbal communication.
Able to manage time independently, adhering to all deadlines including unexpected demands for information and/or additional assignments.
Professionalism in all decision making and use of good judgment based on regulatory and quality standards.
Maintain professional boundaries and confidentiality.
Exercise tact, discretion and judgment in working with a variety of people.
Must possess the ability to make independent decisions when circumstances are warranted.
Ability to be flexible and available to interact with employees at all levels.
Must be self-directed and motivated.
Must be able to manage and cope in sometimes stressful situations.
A high degree of creativity, thorough working knowledge of the business, attention to detail and high level of organizational skills are required.
Bachelor's degree in related health and human service field.
Minimum of three years' experience in human services or regulatory compliance.
Proficiency in computer programs (windows, outlook, adobe, word, excel).
Travel is required. Must have valid NYS Driver’s License.

Nice To Haves

Experience working within a behavioral health, mental health, developmental disabilities, or human services organization strongly preferred.
Knowledge of and experience interpreting and applying New York State Office of Mental Health (OMH) regulations, standards, and guidance is highly preferred.
Familiarity with regulatory oversight functions, including OMH audits, certification reviews, incident reporting requirements, quality improvement initiatives, and corrective action planning.
Experience conducting compliance reviews, investigations, risk assessments, or quality assurance activities within a mental health or healthcare setting.
Working knowledge of applicable federal and state regulations affecting behavioral health providers, including Medicaid, HIPAA, fraud, waste and abuse prevention, and documentation standards.
Experience collaborating with clinical, operational, and leadership teams to ensure compliance with OMH regulations and best practices for service delivery.
Knowledge of regulatory agencies impacting human services programs, including OMH, OPWDD, OASAS, DOH, OCFS.
Demonstrated ability to analyze regulatory requirements, identify areas of risk, and develop recommendations that support continuous quality improvement and regulatory compliance.

Responsibilities

Conduct internal compliance reviews and complete written report summarizing findings.
Conduct fraud investigations, summarize findings and present to executive leadership.
Provide corporate compliance and documentation training to new agency employees during their initial orientation program.
Conduct regulatory/compliance training for leadership and other agency staff as needed.
Provide technical assistance to program leadership and staff on regulatory and compliance issues.
Serve as agency liaison with government agencies conducting reviews of Upstate Caring Partners programs.
Participate in agency activities that may include, meetings, and committee participation (internal and external) that supports internal compliance improvement/development.
Monitor and remain current with state, federal, and third-party insurance regulations and recommend adjustments to the agency compliance program.
Adhere to mandatory abuse reporting laws and HIPPA requirements.