Compliance Manager Quality Assurance

NATALYA FALKOVICH

Address: *** *** **** ******, ********, NY 11214

Phone: 347-***-**** email: **********@*****.***

A reliable, hard-working, caring person with excellent communication and interpersonal skills. Experience in working for people with different social backgrounds, age groups and levels of functioning. Able to work under pressure and deal effectively with crises, sensitive situations, problems, and changes. Detail-oriented, good with paperwork. Proficient in Excel, Word, Outlook, MediSked, Choices, MetricStream, Evolv, eVero etc.

Compliance Manager

YAI - New York, NY

Jul. 2019 to current

•Complete on-going risk assessments of services provided within assigned NYC regions and create compliance plans that ensure the mitigation of all risks identified.

•Assist program operations leaders in determining the origin of risks identified via root cause analysis and ensure corrective action plans are implemented to address the cause of all risks identified.

•Analyse and interpret government standards, laws, and regulations, and provide General Compliance training to programs within assigned regions.

•Investigate and document all reported policy and regulation violation that occur within assigned NYC regions and ensure implementation of appropriate corrective action plans.

•Investigate and document all billing related issues that occur within assigned region and ensure the implementation of appropriate correction action plans.

•Conduct non-billing audit of all programs and services within assigned region to ensure regulatory standards, and internal guidance are met.

•Conduct billing audit of all programs and services within assigned region to ensure regulatory standards, and internal guidance are met.

•Produce written reports of audits conducted, including findings, risks, recommendations, and corrective actions.

•Complete OMIG’s Self-Disclosure Statement, track and reflect the submitted full completed documents in related incidents.

•Interface with and maintains a professional relationship with external entities and oversight agencies such as OPWDD and OMIG.

•Participate in on-going regional leadership meetings to provide new developments in compliance regulations and compliance related policies.

Quality Assurance/ Director Assistant

Community Solutions, Inc. - New York, NY

Sep. 2018 - Jul. 2019

•Conducted routine chart reviews for completion and thoroughness of forms, and at case closing.

•Reviewed and provided feedback on continuity between all program databases (Connections, CSS and PROMIS databases) and Encounter Forms.

•Assisted PD and Supervisor in development of tracking system to monitor pre and post FFT assessments.

•Performed weekly reports for Program Director and Supervisor regarding submitted notes of visited families and provided sessions.

•Made recommendations to PD and Supervisor related to ongoing findings.

•Collected and completed reports for Program Director to share with team members and Area Director, including statistics, outcomes, trends, and other data.

•Communicated chart review assessments to staff via written review and orally.

Quality Assurance Manager

AHRC - New York, NY

Oct. 2014 – Aug. 2018

•Executed monthly Compliance Limited Fiscal and Comprehensive MSC record Quality Assurance reviews within the agency.

•Reported summary reviews to Directors and Compliance Officers.

•Assisted QA Managers with internal and Federal audits and followed up with corrections needed.

•Reviewed mandatory training records, educational background, and work experience of MSC and QA Managers.

•Provided and assisted MSC and QA Managers with resources for public services.

•Reviewed EPOP & PICA documents conducted interviews with direct staff and completed Semi-annual QA review forms.

Consumer Service Coordinator

AHRC/ Walter and Evelyn Redfield ADC - New York, NY

Jun.2006 - Sep. 2014

•Studied the individuals' social and clinical histories; their living and legal arrangements, character traits, strengths, preferences, and safety concerns, their wishes, needs and desires.

•Created Individualized Service Plans and coordinating supports and services to ensure the persons' progress in achieving their desired goals.

•Recommended new services and supports to enrich the persons' lives and meet their changing needs and situations.

•Worked in partnership with the families by responding to their opinions and requests, discussed plans and issues together; kept them updated on new trends and opportunities in the field.

•Kept the individuals' benefits and eligibilities current.

•Advocated for the individuals through contact with service providers, Medical Doctors, community organizations, State and Federal Offices.

•Kept the MSC Record (Chart) in compliance.

Certificate in General Office Worker Program

FEGS Trades & Business School - New York, NY

Oct. 2004 – Feb. 2005

Combined B.A & M.S. in Psychology

Tashkent State University - Tashkent, UZ

Sep.1990 – Jul. 1995

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