The Compliance and Ethics Officer (COE) is responsible for developing, implementing, and maintaining the Agency’s Compliance and Ethics Program and Enterprise Risk Plan. The COE promotes compliance with laws and regulations through risk assessments, the development of policies, employee training, and routine compliance testing. The COE also chairs management-level committees and submits regular reports to the Board regarding compliance and committee findings.

ESSENTIAL FUNCTIONS:

· Develop, implement, and oversee the Agency’s compliance and ethics program and other internal compliance and ethics-related policies and procedures.

· Develop, implement, and maintain an enterprise risk work plan for identification, prioritization, and routine testing of compliance-related risks.

· Actively monitor and review incidents that are reportable externally and internally.

· Chair compliance and incident management committees and participate in additional management committees, as needed.

· Develop and maintain compliance-related training for Agency personnel.

· Report compliance findings and priorities and provide compliance and ethics training to the Board.

· Oversee and perform clinical audits.

· Manage requests for patient records disclosure.

· Other duties as assigned.

DETAILED JOB RESPONSIBILITIES:

· Oversee the development and periodic update of compliance standard operating procedures.

· Develop appropriate key performance indicators as part of a compliance-related performance dashboard.

· Work with Legal Counsel on periodic compliance certifications to regulatory bodies.

· Actively advise Agency executives regarding compliance-related matters.

· Manage and ensure compliance of conflict-of-interest policies, including grants research and Section 4958 excess benefit transactions.

· Manage whistleblower complaints.

· Establish and maintain a regular schedule of clinic visits (in person, remote or via use of compliance liaisons) to ensure necessary visibility of compliance.

· Support financial and billing compliance, consistent with Medicaid and Medicare requirements.

· Foster a culture of compliance across the Agency to create an environment in which compliance is a top priority.

· Develop and maintain a formal assessment of key compliance risk areas for the Agency and monitor emerging risk areas or trends for the Agency and develop appropriate policies and procedures to address these risks.

· Provide proactive support to Agency leadership that identifies potential areas of compliance risk and provide advice and guidance concerning risk mitigation.

· Collaborate with Legal Counsel in the implementation of the Agency’s risk management priorities.

· Actively monitor and review incidents that are reportable internally and externally, including to the New York State Justice Center, OASAS, OCFS, and OMH internally.

· Actively support the resolution of corrective actions of reportable incidents and compliance-related audit findings.

· Maintain an incident reporting platform for use by all personnel.

· Monitor and track violations or similar notices from regulatory agencies.

· Collaborate with the Chief Medical Officer (CMO) and the Chief Human Resources Officer (CHRO) in providing compliance-related training to Agency personnel.

· Support identification and resolution of self-disclosures for Medicaid and Medicare overpayments.

· Actively support leadership to ensure a workplace culture of strong ethics.

· Actively support efforts to achieve business goals in compliance with relevant regulations.

REQUIRED QUALIFICATIONS & COMPETENCIES:

· Bachelor’s degree is required in Management, Health Administration, or a similar field.

· Proficiency in HIPAA, 42 CFR Part 2, and NYS patient and business confidentiality rules.

· Familiarity with Medicaid and Medicare conditions of participation and billing requirements.

· Knowledgeable about current State laws and regulations applicable to Agency clinical operations.

· At least six (6) years of experience ensuring legal and regulatory compliance in a healthcare or human services setting, including behavioral health services in New York State.

· At least four (4) years of experience maintaining an enterprise risk management plan in a healthcare or human services setting.

· The candidate must be comfortable interacting with healthcare providers, as well as with patients who have substance use and mental health disorders.

· Healthcare Compliance certification from a nationally recognized agency.

· Exceptional project management, prioritization, and planning skills, with demonstrated success producing high-quality deliverables on time and within budget.

· Proficient in Microsoft Office and general office electronic resources.

PREFERRED QUALIFICATIONS

· Master’s Degree in public health or similar field.

· Spanish language proficiency.

PERSONAL ATTRIBUTES

· A strong evidence-based/data-driven mindset with an aptitude for analytics; demonstrated ability to structure, visualize, and analyze data.

· Deadline-focused and able to understand the need for a quality product delivered on time.

· Enterprising individual- Well-developed emotional intelligence, generational savvy, and be energized by innovation and change management in a fast-paced, rapidly changing environment with some level of ambiguity.

· Exceptional interpersonal and communication skills are needed to effectively share and engage the entire organization.

ADDITIONAL REQUIREMENTS

· Up to 100% travel within the New York metropolitan area, primarily to existing and new clinic sites. Travel to Albany and Washington D.C., as needed.

· Able to work outside the traditional hours of 9:00 am to 5:00 pm upon request.

SUPERVISORY RESPONSIBILITIES:

Yes.

PHYSICAL REQUIREMENTS

These physical demands are representative of the physical requirements necessary for an employee to successfully perform the essential functions of the job. Reasonable accommodation can be made to enable people with disabilities to perform the described essential functions of the position which are reviewed in each individual case.

While performing the responsibilities of the role, the employee is required to talk and hear. The employee is often required to sit for prolonged periods of time and use his or her hands and fingers to handle or feel. The employee is occasionally required to stand, walk, reach with arms and hands, climb or balance, and stoop, kneel, crouch, or crawl. The employee may be required to lift an object weighing up to 50 lbs., with or without assistance. The vision abilities required by this job include close vision.

LIMITATIONS & DISCLAIMER:

The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position.

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT:

The Agency provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Job Type: Full-time

Pay: $113,000.00 - $131,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Tuition reimbursement
• Vision insurance

Experience level:

• 6 years

Schedule:

• 8 hour shift

People with a criminal record are encouraged to apply

Education:

• Bachelor's (Required)

Experience:

• legal and regulatory compliance in a healthcare setting: 6 years (Required)

License/Certification:

• Healthcare Compliance Certification (Required)

Ability to Commute:

• New York, NY (Required)

Work Location: In person