Compliance & Quality Analyst

Job Description

Job Description

Description : We are Hiring!

Job Posting : Compliance and Quality Analyst

Location : Elmira, NY

Employment Type : Full-Time

Department : Administration / Compliance

Salary : $25.00 - $30.00 / hour

As a regional agency of Catholic Charities of the Diocese of Rochester, Catholic Charities of Chemung and Schuyler Counties has offices in Elmira and Watkins Glen and is rooted in a deeply held belief in the dignity of all people. We work to reduce poverty, promote wellness and self-sufficiency, and advocate for social justice.

If you’re looking for an opportunity to express and explore your passion for helping others, then join a team that truly makes a difference DAILY, in people's lives. Don't miss out on being a part of something special!

General Description

Under the direct supervision of the Regional Compliance Officer (RCO), the Compliance and Quality Analyst is responsible for identifying, auditing, analyzing, and reporting on patterns of regulatory risk, and providing recommendations for adhering to internal controls and regulatory requirements in Medicaid and non-Medicaid funded programs. The Compliance and Quality Analyst will lead efforts to maintain an understanding of internal controls and regulatory requirements across the agency. The Compliance and Quality Analyst conducts complex investigations for incidents, allegations of abuse, and various compliance concerns. Collaborates directly with Program leadership, Regulatory and Law Enforcement entities.

Essential Duties and Responsibilities

• Coordinates with the RCO to develop an annual schedule of reviews (audits) based on identified risk areas or as required by regulatory oversight entities.
• Performs reviews as outlined in the annual audit schedule.
• Examines data, evaluates information, communicates results and follows up on audits in accordance with the agency’s Corporate Compliance Plan, Federal and State Regulations and funder requirements, including Medicaid and non-Medicaid payor compliance and established billing and coding regulations
• Prepares reports on internal and external reviews, program monitoring visits, corrective action plans, and follow-up reviews.
• Investigates and monitors issues of non-compliance and coordinates with the program to implement appropriate internal controls
• Assists RCO with all Agency activities related to privacy of health information required under HIPAA as well as regulatory compliance.
• Works closely with the RCO to ensures all incidents are reported and processed in accordance with agency and regulatory policies and procedures, including entering and updating information on appropriate data systems.
• Conducts formal investigations for incidents and allegations of abuse, neglect or other concerns / events including interviewing employees, individuals served, and others as needed in addition to gathering and analyzing all forms of evidence.
• Partners with Oversight Agencies and Law Enforcement to conduct investigations.
• Responsible for reporting progress, findings, and recommendations of investigations to designated program staff, leadership team, and Incident Review Committee and ensure that all required notifications are made.
• Documents investigation findings and conducts appropriate communication with key stakeholders.
• Provides accurate and written documentation of formal investigations to all designated state or federal oversight agencies as required.
• Assists each Department Director with monitoring of corrective action plans specific to Incident Management and implementation of applicable recommendations by any state or federal oversight entity.
• Completes other duties as assigned

Note : The above description is illustrative of tasks and responsibilities. It is not meant to be all inclusive. Employees are required to follow appropriate supervisory direction and perform other related duties as required.

Qualifications

Relevant years of experience and education will be considered

Additional Qualifications :

Physical Demands / Work Environment : The physical demands / work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, talk, hear, stand, walk, use hands to type and / or perform light lifting. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus. The noise level in the work environment is usually quiet.

Compliance : Adheres to all applicable federal and state laws and regulations including, but not limited to, those governing confidentiality, privacy, program, billing, and documentation standards.

Requirements :