Healthcare Regulatory Specialist- PACE

Job Description

Job Description

Are you passionate about healthcare compliance and ready to make a real impact? VOANS Healthcare is seeking a Healthcare Regulatory Specialist to serve as the division’s go-to expert for all regulatory requirements in PACE and Senior Living programs .

Schedule: Monday-Friday 8:00 AM-5:00 PM

Location: Fully Remote

Salary: $90,000-$100,000 (Based on Experience)

About the Job:

The Healthcare Regulatory Specialist is the division’s primary subject matter expert for all regulatory requirements applicable to their assigned business line (PACE or Senior Living). This includes federal regulations, state rules, CMS guidance, contractual obligations (e.g., PACE three-way agreements), and other compliance mandates. The Regulatory Specialist ensures VOANS Healthcare maintains an accurate, current, and operational understanding of these requirements across regions and programs.

Benefit Highlights:

• 403(b) Retirement Plan
• Career scholarships;
• Continuing career education and leadership programs;
• Medical, Dental and Vision Insurance
• Paid Time Off (Vacation, Holiday & Sick Days)
• NetSpend – Get paid early: Tap into 50% of your earnings after payday

Essentials:

Regulatory Expertise, Interpretation & Consultation
•Serve as the subject matter expert for federal and state regulations applicable to the assigned business line, including CMS requirements, state licensing rules, and contractual obligations (e.g., PACE three-way agreement).
•Provide real-time regulatory consultation to Quality Managers, Clinical Specialists, and program/facility leadership.
•Maintain a centralized repository of regulatory interpretations, guidance documents, and standardized decision tools.

Regulatory Surveillance & Change Management
•Monitor regulatory developments (e.g., CMS memos, state rule changes, federal guidance, association updates).
•Produce concise, actionable regulatory summaries for internal distribution.
•Conduct impact assessments of regulatory changes and outline required operational, documentation, or workflow adjustments.
•Lead planning for compliance with new or revised regulatory requirements, including timelines, responsibilities, and reference materials.

Policy Development & Regulatory Review
•Serve as a primary reviewer of policies and procedures to ensure regulatory accuracy, alignment with federal/state requirements, and internal consistency.
•Maintain policy crosswalks linking regulatory citations to internal policies.
•Participate in drafting and revising policies based on regulatory changes, survey trends, and audit findings.
•Support harmonization of regulatory policy across business lines where appropriate.

Survey Readiness Through Focused Regulatory Audits
•Oversee regulatory components of the internal audit workplan and ensure alignment with survey expectations.
•Conduct focused regulatory audits based on federal/state requirements, areas of known risk, or prior deficiencies.
•Provide documented findings and regulatory interpretations to the Quality Manager and relevant operational leaders.
•Assist Quality Managers and leadership in understanding the regulatory significance of identified issues.
•Maintain readiness tools, crosswalks, and regulatory expectations to support facilities/programs in anticipating survey focus areas.

Internal Audit Program Leadership
•Supervise internal auditors and guide their audit work to ensure accuracy, consistency, and regulatory alignment.
•Ensure audit tools remain up to date with current regulatory requirements and reflect best practices.
•Conduct occasional validation audits (spot checks) to ensure audit integrity and consistency across auditors

•Trend audit findings and prepare reports summarizing regulatory risk patterns, recurring concerns, and opportunities for systemic improvement.
•Collaborate with the VP of Compliance and Performance Excellence and Director of Healthcare Compliance on annual audit workplan development.

Issue Identification & Regulatory Risk Advisement
•Provide regulatory interpretation of issues identified through:
Internal audits
Incidents
Complaints/grievances
Survey findings
Operational escalation
•Ensure the regulatory implications of issues are clearly communicated to the Quality Manager and leadership.
•Advise on what regulatory standards apply, what outcomes must be achieved, and what the minimum regulatory expectation for resolution looks like.
•Collaborate with QMs during the preliminary review of findings to ensure accurate problem definition prior to corrective action planning.
•Support leadership awareness of high-risk regulatory trends and systemic vulnerabilities.

Education, Training & Regulatory Competency Development
•Provide training on the regulatory topics most relevant to the assigned business line.
•Develop regulatory quick reference guides, checklists, and decision aids for Quality Managers, Clinical Specialists, and operational leaders.
•Support onboarding and ongoing competency development for Quality Managers.
•Deliver targeted education following regulatory changes or identified gaps.

High-Risk Process Oversight (Business-Line Specific)
•Senior Living Specialist:
Serve as regulatory resource for infection control, care planning, accident prevention, abuse/ neglect standards, psychotropic medication regulations, PCC documentation expectations, and MDS compliance (in coordination with MDS Manager).
Support facilities in understanding and implementing survey expectations related to these domains.
•PACE Specialist:
Serve as regulatory resource for participant rights, IDT processes, service authorization timeliness, homecare supervisory expectations, contracted provider compliance, grievances/ appeals, and adherence to the PACE three-way agreement.
Support interpretation of CMS audit protocols and expectations for core PACE domains.

Data, Metrics & Dashboard Collaboration
•Identify regulatory performance indicators suitable for dashboard reporting.
•Partner with BI/PBI resources to integrate regulatory metrics into division-wide dashboards.
•Provide analysis and regulatory interpretation of trends in incidents, audits, survey results, and compliance indicators.

Cross-Business-Line Integration & Collaboration
•Promote consistency in regulatory practice across regions and business lines.
•Participate in cross-functional quality and compliance committees.
•Contribute to initiatives focused on standardizing processes, reducing variation, and improving regulatory reliability.

Regulatory Relationship Management
•Maintain positive working relationships with state regulatory bodies, CMS staff, and provider associations.
•Participate in state or regional regulatory meetings, provider forums, or rulemaking sessions as appropriate.
•Serve as a professional, informed point of contact for regulatory matters.

Other:

• Support strong organizational communication and cross-facility learning.
• Actively participate as an engaged member of the Performance Excellence team. In coordination with the team, supports the achievement of organizational objectives.
• Oversight, support, and performance management of team members to ensure they effectively achieve work objectives and maintain high standards of quality and productivity.
• Establish and maintain productive working relationships.
• Maintain the stability and reputation of Volunteers of America National Services by ensuring all activities and operations are performed in compliance with local, State, and Federal laws, regulations and contractual requirements and adheres to organizational policies.
• Is responsible for adherence to program cultural standards including supporting through modeling, coaching, and accountability.
• Protect privacy and maintain confidentiality of all company procedures, results, and information about employees, residents, and families.
• Participate in continuing education classes and any required staff and training meetings. Maintains professional affiliations and any required certifications.
• Act within the scope of his or her authority to practice
• Follow all Volunteers of America National Services policies and procedures and Occupational Safety and Health Administration (OSHA) safety guidelines.
• Perform other duties as required or requested.

Required Qualifications:

• Strong ability to create, build, and maintain productive relationships at all levels.
• Must have a valid driver’s license, proof of insurance and means of transportation.
• Education: Bachelor’s degree in a healthcare-related field such as Healthcare Administration, Health Services Management, Nursing, Public Health, Health Information
• Management, or a related discipline required. A Master’s degree is preferred but not required.
  Licensure and Certification: Requires a recognized healthcare compliance certification, such as Certified in Healthcare Compliance (CHC) or an equivalent compliance or regulatory credential.
• Experience: Requires a minimum of three (3) years of progressively responsible experience in healthcare compliance, regulatory oversight, auditing, or survey management, including direct responsibility for interpreting regulations, supporting audits or surveys, reviewing policies for regulatory alignment, and advising operational or clinical leaders on compliance requirements, preferably in senior care settings such as skilled nursing, assisted living, or PACE.

At VOANS, we celebrate sharing, encouraging and embracing diversity. Equal employment opportunities are available to all without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, parental status, sexual orientation, gender identity, gender expression, genetic information, military and veteran status, and any other characteristic protected by applicable law. We believe that blending individual strengths and unique personal differences nurtures and supports our organizations’ shared commitment to our mission and creates an inclusive and diverse environment where everyone feels valued and has the opportunity to do their personal best