Quality and Compliance Specialist

Employment Type:

Full time

Shift:

Description:

Position Summary

The Quality & Compliance Specialist supports the Quality & Compliance Director in ensuring quality, regulatory compliance, and continuous survey readiness across the PACE program. This role is responsible for quality monitoring, data analysis, regulatory reporting, performance improvement initiatives, infection control tracking, and compliance oversight to improve participant outcomes and operational excellence.

Key Responsibilities

• Collect, analyze, and report quality, compliance, and performance improvement data.
• Monitor quality metrics, maintain scorecards, and identify trends requiring corrective action.
• Develop, implement, and track performance improvement and corrective action plans.
• Conduct audits of clinical and operational processes to ensure regulatory compliance and survey readiness.
• Support regulatory surveys and maintain compliance with CMS, state, federal, and organizational requirements.
• Monitor grievance and appeals processes to ensure regulatory compliance and participant satisfaction.
• Collaborate with interdisciplinary teams to conduct root cause analyses and process evaluations.
• Prepare and submit required quality, compliance, and regulatory reports, including HPMS reporting.
• Coordinate Quality Committee meetings, including agendas, minutes, and supporting materials.
• Monitor infection control and immunization data and support infection prevention initiatives.
• Review and update policies and procedures to ensure ongoing compliance.
• Assist with emergency preparedness, fire drill tracking, and business continuity planning.
• Participate in audits of contracted providers and PACE program sites.
• Maintain confidentiality of participant information and uphold organizational values and ethical standards.

Qualifications

• Bachelor's degree in Healthcare Administration, Nursing, Public Health, Quality Management, or a related field preferred.
• Two (2) years of quality, compliance, performance improvement, or healthcare experience preferred.
• Experience working with frail or elderly populations preferred.
• Strong analytical, problem-solving, organizational, and communication skills.
• Proficiency in Microsoft Office applications, including Excel, Word, and PowerPoint.
• Knowledge of quality improvement principles, regulatory requirements, auditing processes, and data reporting.
• Ability to manage multiple priorities, work independently, and collaborate effectively across teams.
• Limited travel (less than 10%) within the service region may be required.

Position Highlights and Benefits

• Comprehensive benefits package, including Day 1 medical coverage, dental, vision, paid time off, 403(b), and educational assistance.
• Access to earned wages daily through DailyPay.
• Opportunity to earn incentives through the Employee Referral Program.
• Warm, supportive environment with a strong participant-centered focus.
• Comprehensive orientation and ongoing professional development opportunities.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.