Rochester Regional Health · 1 day ago
Regulatory Compliance Specialist
Rochester, NY
Full-time
Onsite
Entry, Mid Level
$63K/yr - $80K/yr
1+ years expRochester Regional Health is seeking a Regulatory Compliance Specialist to manage compliance for the ElderONE Program and Managed Long-Term Care programs. The role involves ensuring adherence to regulatory and accreditation requirements while collaborating with leadership to develop effective compliance programs and processes.
Health CareHospitalMedicalPrimary and Urgent CareWellness
Responsibilities
Ensures the program complies with all applicable Federal and New York State laws, PACE, Licensed Home Care Services Agencies (LHCSA) and NYSDOH regulations. Develops and executes compliance communication tools and training and monitoring programs to ensure ElderONE is surveyed ready every day
Assesses potential non-compliance vulnerabilities, identifies root causes of issues and provides practical business recommendations for corrections
Works with ElderONE leadership and team members to develop recommendations and reach meaningful and appropriate resolutions
Research, interprets and communicates regulation activity, assesses the business impact as a result of state and federal regulations and mandates (existing, new, changing, possible, emerging); provides guidance to ElderONE leadership, works directly with ILS leadership and team members to define and document requirements for implementation and then coordinates with ElderONE leaders and team members to implement the necessary changes
Collaborates with leaders to appropriately plan for regulatory reviews, identifies opportunities and leads activities or projects to meet regulatory standards
This may include designing or redesigning processes, developing policies and procedures, coordinating communications, coordinating and/or implementing educational programs
Maintains current knowledge of accreditation and licensure requirements under the PACE, MLTC, LHCSA programs
Oversees and assists in assessment and action plans for deficiencies prior to surveys
Assists ElderONE in resolution of deficiencies by providing strategies that successfully meet the intent of the standard. Collaborates with leaders to resolve continued non-compliance with standards
Drives performance improvement activities which will achieve compliance with standards
Collaborates with leaders to plan and coordinate activities associated with surveys. Leads and assists in the development of responses to required action plans as a result of surveys
Ensures measurement activities are completed and reported as required following surveys
Works with National PACE Association (NPA), various groups/coalitions (e.g. MLTC/PACE Coalition) and reviews applicable 'list serves' to understand legislation and lobbing activities, which may impact decisions on how to maintain compliance, as well as how new PACE programs are added
Takes lead role in preparing applications, waivers and notifications and related documentation as needed to support strategic goals and objectives
Prepares responses for requests for additional information to government agencies; Updates licensure, application, waiver, notification information based on guidance from NYSDOH and CMS
Tracks status of all licensure, applications, waivers, notifications and manages to completion
Works with various subject matter experts to coordinate activity associated with documents noted above based on the business need
Prepares for and organizes monthly meetings with CMS and NYSDOH Under the guidance of ILS leadership, develops and implements an annual compliance workplan
Qualification
Required
1 year of experience working with a frail or elderly population preferred
Experience with Medicare and Medicaid programs
Strong communication skills and organizational skills
Ability to organize and lead large projects and initiatives across multiple business areas independently
Strong orientation to analytics, deadlines and detail
BS (Required)
Company
Rochester Regional Health
Rochester Regional Health provides integrated health services.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$15.6MKey Investors
New York State Department of HealthMother Cabrini
2025-12-12Grant· $15M
2024-02-27Grant· $0.6M
Leadership Team
Richard Davis
CEO
Recent News
Rochester Business Journal
2025-12-25
Rochester Business Journal
2025-12-19
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