Quality Assurance (QA) Specialist
About The Position
Under the direction of the Director of Compliance, the Quality Assurance (QA) Specialist serves as an independent and objective reviewer to ensure JFSWNY meets all contractual, regulatory, grant, Medicaid, and funder compliance obligations. This role provides agency-wide oversight of program operations, documentation standards, billing practices, and reporting requirements. Within the agency’s NYS OMH-licensed mental health clinic, the QA Specialist monitors adherence to OMH regulations, Medicaid requirements, and managed care standards while maintaining a broader agency-wide compliance focus. This position requires access to highly confidential client, financial, personnel, and board-level information. Maintaining strict confidentiality and professional integrity is essential.
Requirements
- Bachelor’s degree required (related field preferred).
- 2–4 years of compliance, QA, or auditing experience in human services or healthcare.
- Experience with Medicaid-funded programs required.
- Familiarity with NYS OMH regulations strongly preferred.
- Strong analytical and communication skills.
- High level of integrity and discretion.
Nice To Haves
- Familiarity with NYS OMH regulations strongly preferred.
Responsibilities
- Contract & Grant Compliance: Review agency contracts and grant agreements to ensure compliance.
- Develop tracking systems for deliverables and reporting deadlines.
- Conduct internal reviews to confirm alignment with funder expectations.
- Identify non-compliance areas and recommend corrective actions.
- NYS OMH & Medicaid Compliance: Monitor compliance within the NYS OMH-licensed clinic.
- Audit clinical documentation for regulatory standards.
- Review Medicaid and managed care billing practices.
- Assist in preparation for OMH site visits and audits.
- File Auditing & Documentation Review: Pull and review random client files for completeness and compliance.
- Maintain audit logs and compliance reports.
- Provide feedback and recommend process improvements.
- Board Reporting & Governance Support: Prepare compliance summaries for senior leadership and Board committees.
- Provide updates on audit findings and corrective actions.
- Confidentiality & Ethics: Maintain strict confidentiality of client, financial, and board information.
- Adhere to HIPAA, OMH, Medicaid, and agency confidentiality standards.
Benefits
- Health, Dental, and Vision Insurance
- Accrued Paid Time Off (PTO) of 4+ weeks
- 401k plan with agency contribution of 4%
- 13+ observed holidays annually
- Early close on Fridays
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
