Compliance Specialist

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Ensure high standards of care and adherence to regulatory compliance across PACE programs.

• Perform recurring audits as outlined by the Compliance Program.

• Carry out daily internal monitoring and audits to pinpoint areas for enhancement.

• Assess Participant records for accuracy, completeness, consistency, and adherence to care plan directives.

• Review documentation for compliance with both regulatory and organizational standards.

• Detect documentation discrepancies and relay findings to the appropriate IDT members for follow-up.

• Monitor and track corrective actions and opportunities for improvement.

• Gather, organize, and maintain data for reporting and analysis purposes.

• Analyze real-time data and compliance-related information.

• Examine data to uncover trends, patterns, and areas requiring attention.

• Create summaries and reports that support compliance and quality improvement initiatives.

• Stay informed about relevant laws, regulations, policies, and procedures related to PACE services.

• Identify potential deviations from standards of care or organizational requirements.

• Communicate findings and concerns in a clear and professional manner.

• Collaborate with Compliance, clinical leadership, and interdisciplinary teams.

• Engage in compliance, quality, and PACE-related training and professional development.

• Promote accountability, quality, and ongoing improvement.

• Execute other tasks as assigned.

⛳️ Requirements

• Detail-oriented, organized, and adept at handling substantial amounts of information.

• Strong analytical and problem-solving abilities.

• Capable of identifying inconsistencies, trends, and opportunities for improvement.

• Comfortable reviewing healthcare documentation and Participant records.

• Excellent written and verbal communication skills.

• Able to present findings in a professional and constructive manner.

• Team-oriented and effective in collaborating with interdisciplinary teams.

• Capable of working independently while managing multiple priorities and deadlines.

• Proficient in computer skills, including Microsoft Excel and electronic medical record systems.

• Dedicated to maintaining confidentiality and safeguarding Participant information.

• Must be able to sit and work at a computer for extended periods.

• Must maintain focus and attentiveness while examining detailed documentation and data.

• Must be able to utilize standard office and computer equipment.

• Bachelor's degree in healthcare administration, healthcare, business, or a related field is preferred.

• Experience in healthcare compliance, quality assurance, auditing, or data analysis is preferred.

• Experience with healthcare documentation and electronic medical records is preferred.

• Familiarity with PACE regulations, healthcare compliance, or quality programs is a plus.

• Experience with data management, reporting, and analysis tools, including Excel, is preferred.

• Employment is contingent upon successful completion of required background checks, health and safety screenings, and any clearances necessary for healthcare programs.

🏝️ Benefits

• 9 Paid Holidays

• PTO starting at 3 weeks + 1 day per year (accrued from date of hire for full-time employees)

• Medical, Dental, & Vision coverage

• Free Life and AD&D Insurance Plan

• Health Savings and Flexible Spending Accounts

• Short Term Disability Insurance

• Group Voluntary Term Life Insurance for Employee, Spouses, and Dependents

• Paid Parental Leave

• Tuition Reimbursement and Paid Training Opportunities

• Retirement Plan with company annual match

• Mileage Reimbursement at annual IRS rate as applicable

• Training, mentorship, and career development programs