Quality and Compliance Specialist

About the Role

The Quality and Compliance (QC) Specialist maintains a detailed understanding of all current AFA contracts and a basic understanding of all functions within Operations to assist with high-priority issues and projects requiring quick turnaround. They gather information and research contract compliance issues to support Quality and Compliance, Program Managers, and Operations teams. The QC Specialist assists with responding to internal and external requests for information, audits, subpoenas, complaints, and surveys, and fosters a cohesive company-wide approach to quality improvement.

Responsibilities

• Maintain detailed understanding of all current AFA contracts and provider manuals, acting as a contract/manual subject matter expert.
• Act as a liaison between Program Managers/Executive Directors and Operations teams to resolve issues concerning contract/legislative changes, contract deliverables, quality concerns, and other issues impacting customers or Acumen, Inc.
• Serve as contract administrator, focusing on successful completion/implementation of all contract deliverables, including:
  • State audits
  • Emergency management
  • Internal trainings on state and program requirements/business rules
  • Internal reporting of survey results and implementation of corrective action plans
  • Coordination with appropriate state/program on Requests for Information and other communications
• Document management, including forms, program communication, manual updates, and fact sheet updates.
• Identify and develop action plans and/or efficiencies in response to trends and risks across states and programs.
• Independently manage and prioritize multiple projects, making decisions about their relative priority.
• Facilitate cross-department participation to compile accurate documentation for timely responses to Audits, Subpoenas, and RFIs while maintaining detailed records in compliance with HIPAA and contract requirements.
• Package audit results, identify trends, and provide feedback for internal quality improvement projects.
• Oversee the complaint process for tracking and trending purposes and conduct reviews of quality issues and client concerns for trends.
• Assist departments with developing corrective and preventative actions to resolve issues.
• Research, develop, and maintain systems to ensure organizational compliance with all policy, process, contract, and regulatory requirements.
• Lead quality improvement and compliance endeavors using a disciplined and structured problem-solving approach aligned with business priorities.
• Develop project plans and schedules.
• Develop internal and external audits and surveys, then analyze and report results to measure organizational success and establish future goals for improving customer satisfaction.
• Provide staff training and tracking to meet contractual training requirements as needed/requested.
• Occasionally work late or on weekends to meet deadlines and/or high-volume demands.
• Perform other work-related duties as assigned.
• Support the company’s cybersecurity posture by familiarizing themselves with all policies, procedures, standards, and guidelines.

Team Member Responsibilities

• Take personal responsibility for actions, including owning problems and problem-solving without projecting failures onto others or systems.
• Demonstrate excellence in work standards and tenacity in completing tasks.
• Effectively problem-solve and make decisions, including resolving crisis situations and developing resolutions between parties.
• Work well with other team members and departments.
• Interact and cooperate respectfully to efficiently accomplish mutual goals and assignments.
• Request support from the team with ample time to meet deadlines.
• Ensure effectiveness in processes to achieve or seek best practices.

Equipment Used

• Telephone and headset
• Computer with multiple screens
• Copier, scanning system, printer, postage machine, calculator, and fax machines
• Other office equipment as needed

Requirements

• Valid driver’s license within state of residence.
• Valid automobile insurance.
• Ability to communicate both orally and in writing.
• Accuracy and ability to handle responsibility with limited supervision.
• High standards of integrity and honesty.
• Excellent organizational skills, attention to detail, time management, task orientation, good interpersonal skills, patience, perseverance, and follow-through.
• Knowledge of basic computer skills, including Microsoft Word, Excel, and internet email.
• Participate in training to learn and become proficient in all Acumen-specific programs (e.g., Laserfische/AFA DCI).

Qualifications

Minimum Qualifications: As listed in the Requirements section.

Preferred Qualifications: Bachelor’s degree in Social Sciences or related field, or equivalent years of experience in social services, financial management, or human resources.

Skills

Communication Skills

• Excellent communication and relationship skills with all stakeholders, including clients, state entities, and colleagues.
• Ability to effectively and respectfully interact with clients of varying abilities, educational backgrounds, authority, and ethnicities.
• Ability to maintain confidentiality.
• Ability to speak in public, including conducting trainings.
• Ability to communicate diplomatically and respectfully with diverse internal and external customers to accomplish tasks or reach understanding.

Physical and Mental Demands

• Ability to sit for extended periods while entering data into multiple systems.
• Regular use of fingers, hands, arms, and eyes to input data, fold, and/or cut paper.
• Ability to answer phones and respond to team members and internal customers.
• Frequent speaking and responding to internal and external customers via phone and in-person at meetings and presentations.
• Operation and maintenance of office equipment, including computers, copiers, scanning/reading equipment, and calculators, requiring repetitive motion of fingers, hands, arms, and eyes.
• Frequent standing, walking, and talking for an hour or more at a time.
• Vision ability, including close vision, color vision, and the ability to adjust focus.
• Ability to work under stressful conditions with multiple work assignments and specific deadlines.
• Ground and/or air travel upon demand.