Quality and Compliance Supervisor

The Quality and Compliance Supervisor will support the organization’s quality assurance and compliance initiatives by supervising day-to-day quality and compliance operations, monitoring contractual and regulatory requirements, and supporting continuous improvement efforts across programs and departments. This role serves as a liaison between Quality and Compliance leadership, Operations teams, and Program leadership to ensure organizational adherence to Medicaid, State, Federal, and contractual requirements. The Quality and Compliance Supervisor is responsible for overseeing audits, investigations, corrective action planning, reporting, staff support, and compliance tracking activities while promoting a culture of accountability, quality improvement, and operational excellence. This position requires strong analytical, organizational, project management, and leadership skills, as well as the ability to manage multiple priorities in a fast-paced environment.

ROLE AND ESSENTIAL FUNCTIONS

Supervise and support Quality and Compliance team members in daily operations, workload management, and professional development Conduct routine coaching and performance evaluations with staff Support corrective action plans and development planning with staff Assist with onboarding and training team members Establish clear expectations and ensure adherence to the score card measurements Maintain detailed understanding of all current AFA contracts, provider manuals, policies, and applicable State and Federal regulations Serve as a subject matter resource regarding contract compliance, program requirements, and quality assurance processes Act as a liaison between Program Managers, Executive Directors, Operations teams, and other departments to resolve compliance concerns, contractual issues, audit findings, and operational risks Assist with the implementation and oversight of quality assurance and compliance programs, systems, and initiatives across the organization Coordinate and oversee internal and external audits, Requests for Information (RFI), subpoenas, surveys, and regulatory reviews Facilitate cross-department collaboration to compile accurate and timely audit documentation while maintaining compliance with HIPAA and contractual requirements Review audit findings, identify trends and risks, and provide recommendations to leadership to support quality improvement initiatives Monitor and oversee complaint tracking, investigations, trending analysis, and escalation processes Support departments in developing and implementing corrective and preventative action plans to resolve compliance and quality concerns Research, analyze, and communicate changes in legislation, regulations, contracts, and program requirements that may impact operations or organizational compliance Assist in the development, implementation, and maintenance of policies, procedures, forms, reporting tools, and internal controls to support compliance objectives Develop and maintain reports, metrics, dashboards, and tracking systems to measure organizational performance and compliance outcomes Lead or support quality improvement initiatives utilizing structured problem‑solving and process improvement methodologies Assist with the development and delivery of staff trainings related to quality assurance, compliance requirements, audits, and contractual obligations Monitor completion of required trainings and compliance activities to ensure contractual and regulatory standards are met Communicate key risks, audit results, and compliance concerns to leadership to support informed decision‑making and operational improvements Independently manage and prioritize multiple projects and assignments while meeting strict deadlines Occasionally work evenings or weekends as needed to support audits, deadlines, or high‑volume demands Perform other work‑related duties as assigned

QUALIFICATIONS

Bachelor’s degree in public policy, Social Sciences, Business Administration, Healthcare Administration, or related field; or equivalent combination of education and experience Minimum of 2 years of experience in quality assurance, compliance, auditing, healthcare administration, Medicaid programs, or related field Previous experience coordinating audits, compliance reviews, corrective action plans, or regulatory reporting activities Demonstrated leadership, supervisory, or team lead experience preferred Knowledge of Medicaid, State, and Federal regulations and contractual compliance requirements Strong project management, organizational, analytical, and problem‑solving skills Ability to manage multiple priorities and deadlines with limited supervision Excellent written and verbal communication skills Strong attention to detail and ability to maintain confidentiality Experience using Microsoft Office applications including Word, Excel, Outlook, and PowerPoint Ability to learn and become proficient in all Acumen‑specific systems and programs Valid driver’s license within state of residence and valid automobile insurance

PREFERRED QUALIFICATIONS

Experience conducting Medicaid audits and regulatory reviews Experience with quality improvement methodologies and process improvement tools Knowledge of HIPAA requirements and healthcare compliance standards Experience analyzing data, identifying trends, and presenting findings to leadership Experience developing or facilitating staff training programs Previous experience in social services, healthcare operations, or managed care environment

COMMUNICATION SKILLS

Excellent communication and relationship skills with all stakeholders, including clients, state entities, and colleagues Ability to effectively and respectfully interact with client base that has varying levels of ability, educational backgrounds, authority, and ethnicities Ability to maintain confidentiality Ability to speak in public, including trainings Ability to communicate effectively with diverse internal and external customers to accomplish a task or reach an understanding diplomatically and respectfully

RESPONSIBILITIES AS A TEAM MEMBER

Takes personal responsibility for actions. This is demonstrated through owning problems, problem solving and not projecting problems or failures to others or the "system" if not warranted Demonstrates excellence in work standards, is tenacious in completing tasks Able to effectively problem solve and make decisions. To include resolving crisis situations and developing resolutions between parties Works well with other team members and departments Demonstrates the ability to interact and cooperate using respectful relations in order to efficiently accomplish mutual goals and assignments Requests support from team with ample time to accommodate the support request in order to meet deadlines Ensures effectiveness in processes to achieve/seek best practice

EQUIPMENT NORMALLY USED

Telephone and headset, computer, multiple screens, copier, scanning system, printer, postage machine, calculator, and fax machines May use other office equipment as needed

PHYSICAL AND MENTAL DEMANDS

Must be able to sit for extended periods of time entering data into multiple systems The employee is regularly required to use their fingers, hands, arms, and eyes to input data and fold and/or cut paper May be required to answer the phone as well as respond to team members and internal customers Required to operate and maintain a variety of office equipment including a computer, copy machines, scanning and reading equipment and a calculator requiring repetitive motion of the fingers, hands, arms, and eyes Frequently required to stand, walk, and talk for an hour or more Ability to work under stressful conditions that may require handling multiple work assignments with specific deadlines Ground and or air travel upon demand Acumen is an Equal Employment Opportunity (EEO) employer. We embrace diversity in all its form. We provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Note: This job description in no way states or implies that these are the only duties to be performed by the employee in this position. Employees will be required to follow any other job‑related instructions and to perform other job‑related duties as requested by their supervisor. #J-18808-Ljbffr Acumen Fiscal Agent, LLC