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About the Role
As Compliance Officer at LTE Care Plus, you’ll safeguard our ethical and legal integrity as a 501(c)(3) nonprofit while ensuring every ABA and Early Intervention (EI) service meets Medicaid, OMH, and other regulatory standards. You’ll partner with clinical, billing, and administrative teams to strengthen documentation, prevent risk, and build a culture of transparency, accountability, and continuous improvement.
Responsibilities
- Monitor and enforce compliance with federal and state rules (Medicaid NY, OMH, OPWDD, NYS DOH, CMS, BACB), with a focus on ABA/EI billing and documentation requirements.
- Develop, update, and socialize agency-wide compliance policies; deliver annual training on confidentiality, billing, supervision, and clinical documentation.
- Conduct quarterly audits and targeted reviews of clinical records, billing reports, supervision logs, and intake procedures.
- Identify compliance risks, lead investigations, and implement corrective action plans with clear follow-up and documentation.
- Audit Medicaid and insurance claims for accuracy; verify treatment plans, session notes, and authorizations; ensure services occur only within valid authorization windows.
- Monitor reassessment timelines to avoid service interruptions or denials.
- Partner with clinical, intake, and billing teams to resolve discrepancies and strengthen internal controls.
- Prepare quarterly and annual compliance reports for the Executive Director and Board; maintain audit, training, and incident records; support external audits or regulatory inquiries.
Requirements
- Bachelor’s degree required.
- 3–5+ years in healthcare or nonprofit compliance, ideally in behavioral health, ABA, or Medicaid-funded programs.
- Strong working knowledge of Medicaid NY regulations, including billing, supervision, and documentation for ABA/EI.
- Familiarity with BACB Ethics Code, HIPAA, OMH, OPWDD, and NYS DOH frameworks.
- Experience with 501(c)(3) governance and compliance reporting is a plus.
- Proven ability to conduct audits, implement compliance protocols, and respond to regulatory inquiries or investigations.
- Highly analytical with excellent communication, problem-solving, and attention to detail.
- Comfortable working independently and collaborating across clinical, administrative, and billing teams.
- Proficient with EHR systems and compliance tracking tools; experience with parent training requirements and clinical supervision standards is a plus.
Skills
- ABA/EI billing and documentation
- Compliance policies
- Confidentiality
- Clinical documentation
- Auditing
- Risk management
- Medicaid claims
- Authorization verification
- Cross-functional collaboration
- Reporting
- EHR systems
- Compliance tracking tools
Location
- Melville, NY
Work Type
- Hybrid
- Full-time
Experience Level
- 3-5+ years
Education Level
- Bachelor's degree
- Master's degree preferred
Salary/Compensations
- $70,000–$100,000
Benefits
- Mission-driven work
- Collaborative, supportive leadership team
- Opportunities to shape compliance strategy
About the Company
- LTE Care Plus is a 501(c)(3) nonprofit organization.