Job Description

Delphi Rise is a small but mighty , mission driven nonprofit with nearly 90 years of experience providing substance use supports, behavioral health services, and community based supports. We are deeply values led and relationship centered, with a strong organizational culture grounded in dignity, accountability, and trust. While our size allows us to stay connected and nimble, our impact is broad and our standards are high.

Our work is rooted in a long history of serving people with integrity and respect, and that commitment extends to how we operate internally. We take compliance seriously because it protects our clients, our staff, our licensure, and the public resources entrusted to us.

This role is for a highly experienced healthcare or human services professional who understands Medicaid funded systems and the realities of working within regulated environments. We are looking for someone who brings sound judgment, strong organizational instincts, and exceptional attention to detail, and who values being part of a collaborative, mission focused team.

This is not an entry level role . It is best suited for someone with years of experience in healthcare, behavioral health, or human services, including direct exposure to Medicaid billing and regulatory requirements. The position is primarily remote and may be an excellent fit for someone transitioning from a long career who wants meaningful, part time work with real responsibility and impact.

What we need is a steady, thoughtful professional who helps keep the organization aligned, audit ready, and on track so our programs can continue to serve the community with excellence.

Compensation: $50 to $65 per hour, depending on experience
Hours: Part Time, approximately 15 to 22 hours per week

Position Summary

The Compliance Officer supports the agency’s organizational compliance program with a focus on Medicaid billing integrity, HIPAA and 42 CFR Part 2 privacy oversight, policy management, incident reporting, internal audits, and regulatory readiness. This role works closely with executive leadership, billing, HR, Quality, and program leadership to promote a culture of ethics, accountability, and continuous improvement.

The position is primarily remote, with limited on site requirements for training and scheduled meetings that will be planned well in advance.

Key Responsibilities1. Medicaid Billing and Documentation Oversight

• Conduct routine internal reviews of Medicaid claims to ensure accuracy, proper coding, medical necessity, and documentation readiness prior to billing
• Identify billing errors, research root causes, and coordinate corrective actions with supervisors
• Maintain detailed logs of billing reviews, trends, and quality findings
• Assist with preparation for and follow up related to OMIG, OASAS, and funder audits

2. Overpayment Identification and Self Disclosure Support

• Monitor potential overpayments and support the CEO and CFO in determining whether OMIG self disclosure is required
• Track remediation steps, corrective actions, and follow through to prevent recurrence
• Maintain documentation and timelines required for audit readiness

3. HIPAA and 42 CFR Part 2 Compliance

• Support privacy incident intake, logging, investigation, and resolution
• Maintain and update HIPAA and 42 CFR Part 2 policies
• Coordinate access reviews, minimum necessary controls, and privacy related training
• Ensure Business Associate Agreements are in place and tracked for partners who access PHI

4. Organizational Policy Management

• With support from the Executive Administrator, maintain a centralized policy library and annual review schedule
• Ensure regulatory updates from OASAS, Medicaid, HUD, DOL, IRS, and other agencies are incorporated into relevant policies
• Coordinate policy updates with supervisors and support staff rollout

5. Staff Training and Attestation Tracking

• Maintain compliance related training records for all staff
• Coordinate new hire and annual compliance training, including HIPAA, 42 CFR Part 2, fraud and abuse prevention, documentation expectations, and the Code of Conduct
• Track annual staff attestations, including Code of Conduct, Conflict of Interest, HIPAA, and billing practices

6. Incident Reporting and Compliance Hotline Management

• Oversee the agency incident reporting process, including intake, documentation, escalation, follow up, and tracking
• Identify trends and collaborate with supervisors to develop corrective actions and improvements
• Ensure all documentation is complete, timely, and audit ready

7. Contract and Vendor Compliance

• Track and maintain Business Associate Agreements, MOUs, subcontractor agreements, and compliance related attachments
• Assist with monitoring vendor documentation such as credentials, insurance, and training requirements

8. Audit Readiness and Regulatory Updates

• Maintain well organized records for audits, including billing samples, corrective action plans, policies, and training documentation
• Monitor regulatory updates from Medicaid, OMIG, OASAS, HUD, and other funders and summarize key impacts for leadership

9. Governance Support

• Prepare materials for and support the quarterly Compliance Committee and Board compliance updates, including dashboards, summaries, and audit findings
• Assist with follow up items and ensure all documentation is stored appropriately

Education and Experience

• Bachelor’s degree in healthcare administration, public health, business, social work, or a related field preferred
• Equivalent combination of education and significant professional experience in healthcare or human services compliance will be considered
• Advanced certifications or specialized training in healthcare compliance, Medicaid billing, privacy, or risk management are a plus

Required Qualifications

Applicants must meet the following to be considered:

• Demonstrated experience in Medicaid billing environments, healthcare compliance, behavioral health, or human services
• Working knowledge of HIPAA, 42 CFR Part 2, and OASAS 822 regulations
• Strong organizational, documentation, and communication skills
• Proven ability to manage confidential and sensitive information with professionalism and discretion
• Proficiency with EMR systems, databases, and Microsoft 365

Preferred Qualifications

• Experience with OMIG compliance programs, internal audits, or Medicaid billing quality review
• Background working within OASAS, HUD, or other health and human services regulatory frameworks
• Training or experience in quality improvement, risk management, or program accreditation

Equal Opportunity Employer

Delphi Rise is an Equal Opportunity Employer. We are committed to creating an inclusive environment for all employees and applicants. All qualified individuals will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, protected veteran status, or any other legally protected characteristic.

To Apply

Please contact edejesus@delphirise.org to submit your resume, request additional information, or request an application.

Pay: $50.00 - $65.00 per hour

Expected hours: 15.0 – 22.0 per week

Benefits:

• 401(k) matching
• Flexible schedule
• Retirement plan

Work Location: Hybrid remote in Rochester, NY 14624

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