Quality & Compliance Specialist

Job Description

Job Description

Description:

ROLE AND ESSENTIAL FUNCTIONS

The Quality and Compliance (QC) Specialist must maintain a detailed understanding of all current AFA contracts, as well as a basic understanding of all functions within Operations in order to assist with high-priority issues and projects that require a quick turnaround. They must have the ability to gather information and research contract compliance issues in order to support Quality and Compliance, Program Managers, and Operations teams. The QC Specialist will assist the Quality and Compliance Department with responding to internal and external requests for information, audits, subpoenas, complaints, and surveys. This person must have excellent project management skills and be able to foster a cohesive company-wide-team approach to quality improvement.

• Maintain detailed understanding of all current AFA contracts and provider manuals, acting as a contract/manual subject matter expert
• Act as a liaison between the Program Managers/ Executive Directors and Operations teams, communicating and helping to resolve any issues concerning contract /legislative changes, contract deliverables, quality concerns, and other various issues that may directly impact the customer 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 any corrective action plans, and 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 at once and makes decisions about their relative priority at any given time
• Facilitate cross-department participation to compile accurate documentation needed for timely responses to Audits, Subpoenas and RFI, while maintaining detailed records as they relate to the request 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 the development of corrective and preventatives actions necessary to resolve further issues
• Research, develop, and maintain systems to ensure the organization complies with all policy, process, contract, and regulatory requirements
• Lead quality improvement and compliance endeavors with a disciplined and structured problem-solving approach that aligns to 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 to improve customer satisfaction
• Provide staff training and tracking in support of meeting contractual training requirements as needed/requested
• Occasionally work late or on weekends as needed to ensure deadlines and/or high-volume demands are met
• Perform other work-related duties as assigned
• ALL Acumen employees will be vigilant to support the positive compliant cybersecurity company posture by familiarizing themselves with all policies, procedures, standards, and guidelines and act.

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

QUALIFICATIONS

• Valid driver’s license within state of residence
• Valid automobile insurance
• Ability to communicate both orally and in writing
• Accuracy and the ability to handle responsibility with limited supervision
• High standards of integrity and honesty
• Demonstrate excellent organizational skills, attention to detail, time management, task oriented, good interpersonal skills, patience, perseverance, and follow through skills
• Knowledge of basic computer skills to include Microsoft Word, Excel and internet e-mail experience
• Must participate in training necessary to learn and become proficient in all Acumen specific programs (i.e. Laserfiche/AFA DCI)

PREFERRED QUALIFICATIONS

• Bachelor’s degree in social sciences or other related field, or equivalent years of experience in social services, financial management or human resources.

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 in0 public, including trainings
• Ability to communicate effectively with diverse internal and external customers to accomplish a task or reach an understanding diplomatically and respectfully

PHYSICAL AND MENTAL DEMANDS

The demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job, with or without accommodation.

• The employee 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
• The employee may be required to answer the phone as well as respond to team members and internal customers
• The employee is frequently required to speak to and appropriately respond to customers, both internal and external, on the phone as well as in-person at meetings and presentations on multiple times per day and on any given day, week, month or year
• The employee is 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
• The employee is frequently required to stand, walk, and talk for an hour or more
• Vision ability is required to do the job, including close vision, color vision and the ability to adjust focus
• Ability to work under stressful conditions that may require handling multiple work assignments with specific deadlines
• Ground and or Air travel upon demand