Regulatory Compliance Specialist

Overview

The Regulatory Compliance Specialist plays a critical role in ensuring Behavioral Health Allies (BHA) operates in full compliance with applicable federal, state, and local laws, regulations, accreditation standards, and contractual requirements, with a specific emphasis on Kansas and Missouri regulatory frameworks. Working closely with the Director of Safety, Risk and Compliance, this position supports the development, implementation, monitoring, and continuous improvement of BHA’s compliance, privacy, and risk management programs.

This role supports compliance with oversight agencies including, but not limited to, the Kansas Department of Children and Families, Missouri Department of Mental Health, Missouri Department of Social Services, Missouri Department of Elementary and Secondary Education and Centers for Medicare & Medicaid Services, and applicable Medicaid Managed Care Organizations. Responsibilities include conducting internal reviews and audits, tracking regulatory changes, assisting with enterprise-wide risk assessments, supporting external surveys and third-party audits, and maintaining accurate compliance documentation.

The Regulatory Compliance Specialist serves as a key partner to cross-functional teams, helping translate regulatory and contractual requirements into practical, workable policies and procedures that support safe, ethical, and high-quality services for individuals with developmental disabilities and complex behavioral needs, while reinforcing adherence to BHA’s mission and core values.

Audit, Compliance, and Risk Management

• Assist the Director of Safety, Risk and Compliance with internal reviews, audits, and compliance assessments to verify adherence to applicable federal and state laws, CMS Conditions of Participation, Medicaid waiver requirements, state plan services, accreditation standards, payer contracts, and organizational policies.
• Support compliance monitoring related to Kansas and Missouri Medicaid programs, including HCBS waivers, MCO requirements, and state-specific provider manuals and regulations.
• Identify, document, and organize compliance findings, trends, and potential risk areas; assist in developing and tracking corrective action plans, plans of correction (POCs), and quality improvement initiatives.
• Verify compliance with insurer rules, Medicare, Medicaid, HIPAA, and applicable Kansas and Missouri statutes, administrative regulations, and DMH/KDADS requirements.
• Assist in conducting enterprise-wide risk assessments, including identification of operational, regulatory, privacy, and compliance risks.
• Support preparation for, participation in, and follow-up from third-party audits, surveys, licensing reviews, and regulatory inquiries.

Policy Development and Document Control

• Assist with the development, review, implementation, and revision of policies, procedures, and compliance-related documents based on regulatory changes and organizational needs.
• Coordinate with departments and cross-functional teams to ensure documents are reviewed, updated, and approved within required time frames.
• Perform document control functions, including tracking, formatting, version control, distribution, and archiving.
• Evaluate document organization, proofread materials, and perform quality checks prior to finalization.

Regulatory Monitoring and Reporting

• Monitor and stay informed of changes in federal, state, and local regulations impacting healthcare and behavioral health services, including CMS guidance, Kansas and Missouri statutes and administrative rules, DMH directives, and Medicaid policy updates.
• Assist in interpreting regulatory guidance and translating requirements into actionable operational practices.
• Support timely and accurate reporting to regulatory agencies, state oversight bodies, and internal leadership, as required by CMS, DMH, and contractual obligations.
• Assist with maintaining readiness for unannounced surveys, audits, and site visits.

Privacy, Complaints, and Investigations

• Receive, document, investigate, and assist in resolving compliance- and privacy-related complaints or concerns.
• Maintain compliance, privacy, and investigation logs…