QUALITY & COMPLIANCE OFFICER

J.M. Murray Center, Inc.•Munsons Corners, NY

1d•Hybrid

About The Position

The Quality and Compliance Officer supports the Director of Quality Assurance and Compliance in maintaining operational integrity across JM Murray’s programs serving over 1,100 individuals. This role balances a focus on promoting a culture of compliance—preventing and detecting fraud, waste, and abuse—with a rigorous commitment to quality assurance through OPWDD incident management. Ultimately, proactive incident management serves as the essential safeguard for the safety and dignity of our service recipients, while the compliance program ensures the legal and financial protection of JM Murray.

Requirements

Excellent organizational, time management, written and verbal communication skills.
Ability to work efficiently and productively in an independent and collaborative environment.
Must be able to travel to local and regional locations for meetings and compliance tasks and activities.
Flexibility to adjust to changes in priorities and assignments.
Flexibility to work occasional hours outside of regular schedule for meetings or investigation activities.
Will be required to complete the NYS Justice Center training on Investigations within 30 days or the next available course, whichever is sooner.
New York State Driver’s License that meets Company requirements.

Nice To Haves

An Associate’s Degree is preferred.
Experience in Medicaid Billing and OPWDD/OMH Services highly desired.
At least 1-3 years of prior experience in health care compliance audits is highly desired.
Experience in OPWDD incident management is highly desired.

Responsibilities

Conducting, reporting, and following up on all assigned compliance and HIPAA audits.
Actively participating in the JM Murray Compliance Committee.
Leading investigations into incidents and allegations of abuse or neglect in strict accordance with Justice Center and OPWDD regulations.
Conducting site observations and file reviews.
Facilitating required staff training on reporting rights and non-compliance.
Providing actionable feedback to improve service outcomes and ensure organizational excellence.
Conducting, completing, reporting and following up on all assigned compliance and HIPPA audits.
Conducting assigned Quality Assurance job tasks that include Training, Incident Investigations, and Quality Assurance programs and tasks for the JM Murray Services division.
Following a schedule and selection of files, set forth by the Director of Quality and Compliance, to audit for each service area within the required timeframe.
Using the current audit tools and recommending changes to the Director of Quality and Compliance, when there are updates to OPWDD/OMH billing standards.
Following the procedures for Internal Billing Audits and Monthly Compliance Group meetings, including but not limited to the documentation corrective actions needed for audited files and follow up on reviews to ensure corrections are made by services leadership.
Reporting any trends noted, and/or if corrective actions are not being addressed to the Director of Quality and Compliance.
Assisting in preparing a quarterly summary report of internal billing audits for the Director of Quality and Compliance and the President for review prior to the Quarterly Compliance Meeting.
Maintaining updated knowledge of billing standards; ensure that audit tools are based on current information and updated as required.
Expanding audit schedule and increasing oversight for a particular individual or program based on emerging trends or patterns of concerns.
Responsible for the clerical aspects of the committee, including preparation of the agenda and materials for each meeting for the Director of Quality and Compliance.
Distributing agenda and materials in advance to all committee members.
Coordinating meeting locations and any logistical needs for meeting, such as IT set up, TEAMS/WebEx, etc.
Taking and preparing the minutes for each meeting, distributing to committee members and saving in the appropriate Compliance Folder, following JM Murray file name standards.
Presenting the quarterly summary report at Committee Meetings, and any other assigned topics.
Reviewing service notes, service plans, billing records, time records and other documentation as part of a compliance investigations.
Reviewing records through the JM Murray Electronic Medical Record, and the efficient use of equipment such as a computer, laptop, and/or a tablet.
Conducting interviews and taking statements from witnesses and employees as part of a compliance investigation.
Preparing concise, comprehensive reports and summaries of assigned documentation reviews as part of investigative summaries and reports.
Conducting Contact Tracing for assigned employee cases, maintaining the utmost confidentiality of all information obtained in the process, IF required by a federal Public Health Emergency or NY State of Emergency.
Conducting the annual HIPAA Risk Assessment audits.
Preparing a concise and comprehensive report on the outcomes of the assessment audits.
Assisting the Director of Quality and Compliance with assigned individual compliance activities, including obtaining and collecting documentation and updating on progress.
Providing clerical support for compliance responsibilities and initiatives including but not limited to updates to policies, consistency checks, managing and filing compliance documents, updating spreadsheets and files, preparation of training packets, mailings, etc.
Attending entrance and exit conferences and meetings for external audits and reviews.
Collecting and filing compliance and HIPAA related documentation and notices.
Conducting and documenting incident investigations according to established procedures.
Submitting investigation reports that fully and accurately document the investigation process, outcomes and recommendations, within established timeframes.
Interviewing alleged targets, victims, and witnesses according to established procedures as needed.
Monitoring and updating IRMA (Incident Reporting and Management Application) and WISR (Web Submission of Investigation Reporting) for all reported incidents and responding according to reports received.
Attending and participating in Incident Review Committee meetings, as assigned.
Assisting the Director in the preparation of agenda, materials, etc. and with presenting information to the committee.
Completing minutes for committee meetings, as assigned.
Assisting the Director, as requested, with any reporting on Incident Management, including data for trend reports.
Conducting and reporting on random quality assurance audits of services that are provided.
Auditing may include meeting with people receiving services and their families, record reviews and/or physical observation of service delivery both on and off site to ensure service environments meet the physical social, developmental and safety needs of the persons served.
Observations will include monitoring that individual interests are respected and that civil, human and legal rights are protected.
Conducting and reporting on the completion of the annual satisfaction survey of service recipients.
Submitting annual report to the Director within an established timeframe.
Attending and participating in Quality Assurance Committee Meetings, including assistance to prepare agenda, materials, etc.
Completing minutes for committee meetings, as assigned.
Conducting training, as assigned, for small or large groups.
Presenting compliance topics and training at company Communication Meetings, staff meetings, etc.
Attending all required and assigned training and meetings.
Representing JM Murray as a representative on local and regional committees, as assigned.
Conducting self in a manner as to always contribute to maximum individual growth and in accordance with all regulations, the Code of Ethics and Company policy and procedures.
Representing JM Murray and the JM Murray mission in a positive manner, treating people with respect and dignity.
Performing additional duties and responsibilities, as assigned.