Compliance Officer

East Meadow, NY

Reporting to the NQP Executive Committee (Board) and the Executive Director, the Compliance Officer must plan and execute compliance and operational reviews/internal audits, manage external payer audits and make recommendations for improvements to processes, systems and controls that ensure compliance with payer medical and reimbursement requirements consistent with the NYS DSRIP Specifications and Reporting manual. The CO manages the planning, design and maintenance of the DSRIP compliance programs, management reporting, compliance education and training program, and compliance policies and procedures. Provides effective guidance regarding matters of compliance and ethical business practices. Investigates and resolves compliance issues, including hotline call investigations and audit and monitoring processes directly related to NQP compliance issues. Responsible for advising the Board in regulatory compliance, maintaining the effectiveness of the Compliance Program and serving as a key resource for Medicaid reimbursement information.

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