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Contract Compliance, Audit, & Reporting Specialist

Easterseals MORC

Easterseals MORC is hiring for a Contract Compliance, Audit, & Reporting Specialist to help make a difference and become part of something bigger than yourself! We are looking for Game Changers! The types of people who wake up excited to make a difference. The superheroes of their field who care about the people they serve. If that sounds like you, we want you on our team. Benefits of Being a Superhero Low-cost Dental/Health/Vision insurance Dependent care reimbursement, and up to 5 days paid FMLA for maternity, paternity, foster care and adoption. Generous 401K retirement plan Paid Leave Options Available Up to $125 bonus for taking 5 days off in a row. 10 paid holidays and 3 floating holidays (Over 30 days total of paid time off) Wellness Programs We are a PSLF (Public Service Loan Forgiveness) Employer. We provide bonuses and extra incentives to reward hard work & dedication. Mileage reimbursement in accordance with IRS rate. Free financial planning services through our partnerships with the LoVasco Consulting Group, and SoFi. Student loan repayment options Pet Insurance The Contract Compliance, Audit, and Reporting Specialist is responsible for monitoring contracted service provider and funder requirements for compliance, including Certified Community Behavioral Health Clinic (CCBHC) Designated Collaborating Organizations (DCO’s) and other contracted service provider requirements. Leads audit and reporting activities to monitor compliance with requirements, metric expectations, corrective actions, and compliance across DCO and contracted network providers. This role collaborates closely with Contract Management, Quality Assurance, Program Leadership, Corporate Compliance, and contracted network providers and partners to ensure required standards are met and sustained. This position serves as a liaison between the organization and contracted network providers, supporting effective oversight, communication, and continuous quality improvement. This role also ensures timely monitoring, documentation, reporting, and follow-up related to provider performance, contract requirements, and compliance expectations. Key Responsibilities Audit administration - This function is the backbone of the monitoring process. It includes creating and maintaining the audit schedule, tracking deadlines, organizing records, assigning follow-up tasks, and making sure audits are completed on time and documented consistently. Strong audit administration also means keeping a clear record of findings, corrections, and re-review dates so the contracted provider organization can demonstrate compliance and quality improvement over time. Periodic audits - Periodic audits are scheduled, and reviews performed, at regular intervals to confirm that contracted service provider programs, including required processes and procedures are meeting required standards. These audits help identify issues early before they become larger compliance or service delivery problems. They also give leadership a structured way to monitor trends, compare performance over time, and prioritize support where needed. Credentialing audits - Credentialing audits verify that contracted service providers meet required qualifications, licenses, certifications, training, and enrollment standards. This includes checking that documentation is complete, current, and aligned with funder and regulatory expectations. Credentialing audits are especially important because they help reduce risk related to provider eligibility, scope of practice, and network integrity. Administrative May audits - Desk audits are document-based reviews conducted without necessarily going on-site. They are used to examine records, reports, attestations, and other evidence to determine whether a contracted service provider is meeting expectations. Desk audits are efficient for reviewing compliance trends and are especially useful for recurring monitoring of contractual or regulatory requirements. Training compliance monitoring - This function ensures required trainings are completed, tracked, and kept up to date for contracted service providers. It includes monitoring required orientations, annual refreshers, evidence-based practice training, safety-related training, and funder-specific education. Ongoing tracking ensures network provider readiness, reduces risk, and supports service quality. Attestations - Attestations are formal confirmations that required information, practices, or conditions are true and accurate. Monitoring attestations means making sure they are collected on time, completed properly, and supported by documentation when needed. This activity protects Easterseals MORC by creating a record that contracted service providers understand and acknowledge key compliance expectations. Policy and procedure compliance - This function verifies that contracted service providers are following contract requirements, including policies and procedures. It includes reviewing and ensuring that practices match written standards, compliance with any updates that have been communicated, and whether staff are using the correct processes in day-to-day work. When gaps are identified, the role helps coordinate education, corrective action, and follow-up. MiChoice and other regulatory reporting – May support activities related to MiChoice funder and regulatory requirements. Collaborates with the Reporting and Business Intelligence (RBI) Team to develop management reports and monitoring tools - This function includes working with the RBI team to develop management reporting tools for Easterseals MORC and contracted service providers to identify, and reports problems related to authorization accuracy, diagnosis coding, and related documentation concerns. These monitoring and reporting tools are designed to help prevent billing problems, service delays, and compliance findings. FWA monitoring - Fraud, waste, and abuse monitoring related to DCO and Provider Network to identify patterns or behaviors that could create legal, financial, or ethical risk, such as billing irregularities, improper documentation, duplicate services, or suspicious referral patterns. The goal is not just detection, but prevention through education, controls, and escalation when needed. Conflict monitoring - Conflict monitoring involves identifying situations that could create conflicts of interest, referral concerns, self-dealing, or other relationship-based risks. It helps ensure decisions are made appropriately and that provider relationships do not compromise compliance or fairness. This type of monitoring is especially important in network management and contract oversight. Contracted Service Provider PIP/CAP follow-up - This function involves the review and follow-up of Performance Improvement Plans and Corrective Action Plans. The role tracks the remediation of concerns/issues identified, that deadlines are met, and that identified issues are effectively addressed and not recurring. This function ensures that corrective action is effective and leads to sustained change. CCBHC DCO Compliance Monitoring - This function ensures that Certified Community Behavioral Health Clinic DCO requirements are met, including required training, evidence-based practice, credentialing, and staffing expectations in alignment with CCBHC requirements. Quality alignment – This role helps ensure that contracted service provider auditing and compliance activities align with broader quality goals and expectations. Rather than treating audits as isolated tasks, this function helps ensure that findings inform quality improvement, service enhancements, and leadership priorities. This creates a stronger link between what is measured, what is corrected, and what ultimately improves outcomes for people served. Reporting to Corporate Compliance - This function involves sharing findings, trends, risks, and follow-up actions with the Corporate Compliance team. It ensures leadership has visibility into provider monitoring results, compliance concerns, and unresolved issues. Provides quarterly performance updates to Leadership regarding monitoring efforts, trends, compliance issues, and areas of improvement. #J-18808-Ljbffr Easterseals MORC

Vacancy posted 4 days ago
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