Quality Assurance & Compliance Analyst
Quality Assurance & Compliance Analyst
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
- Conduct regular and targeted audits of case files billing and service delivery to ensure compliance with Medicaid waiver and DMAS regulations
- Develop and maintain monitoring tools checklists and audit logs
- Identify compliance gaps or risks and recommend appropriate corrective action plans
- Interpret DMAS provider manuals memos and regulatory updates
- Track regulatory changes and communicate implications to leadership and relevant teams
- Collaborate with internal teams to ensure policies procedures and practices remain compliant with evolving DMAS regulations
- Stay current on federal and state medicaid regulations DMAS manuals and healthcare compliance best practices.
- Handle documentation and internal response for critical incident reports and suspected fraud or abuse
- Work with appropriate departments to address incidents ensuring proper resolution and reporting
- Prepare written summaries and compliance reports for leadership including audit findings trends and recommendations
- Maintain organized records of audit results remediation plans and compliance activities
- Monitor adherence to HIPAA and confidentiality standards
- Provide guidance and training to staff on Medicaid waiver regulations documentation standards and compliance requirements
- Support preparation for external audits or monitoring visits from DMAS or other entities
- Uses care and discretion when handling personal information and client records
- Participates in required company calls team meetings and ongoing compliance training
3 years in compliance auditing or quality assurance (Medicaid waiver healthcare human services or legal setting).
In-depth knowledge of DMAS Medicaid waiver regulations and provider manuals - HUGE PLUS!
Strong analytical and auditing skills with excellent attention to detail
Excellent verbal and written communication skills with the ability to translate regulatory language into clear actionable guidance
Proficiency in Microsoft Office Suite (Excel Word PowerPoint) Google Workspace and electronic health/record systems
Ability to handle sensitive information with confidentiality and integrity
Able to pass a background check provide 2 professional references.
Bonus points: Experience with DMAS compliance audits or a compliance/QA certification.
Perks & Benefits
Weve got you covered with:
- Paid Training (we set you up for success!)
- PTO
- 11 Paid Holidays
- Medical Dental & Vision Insurance
- Disability Life and AD&Dcompany paid!
- 401K with Employer Match
- EAP & Telemedicine Access
- Flexible Spending Accounts & Dependent Care Options
- Supplemental Insurance (Accident Cancer Critical Care & more)
- Annual Tech Stipends
- Fun Employee Perks (discounts on car rentals Verizon AAA oil changes & more!)
Analytical. Ethical. Detail-driven.
If that sounds like you Apply today at !
This is a remote position.
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability status protected veteran status sexual orientation pregnancy childbirth or other related conditions (including lactation) age (over 40) marital status disability or gender identity.
Required Experience:
IC
Employment Type
Full-Time
