Quality Compliance Manager

ABOUT THE COMPANY 

Acumen, LLC. is one of the nation's leading fiscal agents offering a portfolio of innovative financial management services backed by superior customer service. Our passion is to help people lead independent lives through exceptional participant-directed programs. Acumen is a great place to work. Our employees make a positive difference in our client’s lives by what they do. Among many benefits to working here, we offer medical, dental and vision coverage, generous paid time off, and incentive bonuses to those who qualify.

OVERVIEW AND ESSENTIAL JOB FUNCTIONS

The Manager of Quality and Compliance promotes contractual compliance and interprets Medicaid, State and Federal funding regulations as it relates to our business. This role involves developing, implementing and maintaining effective quality management processes and systems.

• 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 conducts reviews of quality issues and client concerns for trends
• Assists departments with the development of corrective and preventative actions necessary to resolve further issues
• Develops and maintains programs and systems through internal self-audits to ensure the organization complies with all policy, process and contract requirements
• Leads quality improvement and compliance endeavors with a disciplined and structured problem solving approach that aligns to business priorities
• Evaluate internal and external audits and surveys to measure organizational success and establish future goals to improve customer satisfaction
• Identify, evaluate and analyze the impact of state legislative and regulatory issues and advise management on impact/risks
• Upon request will review and analyze laws, regulations, insurance and contracts to identify organizational requirements and guide internal compliance efforts to satisfy those requirements
• Stay up to date with industry trends and regulations to ensure the company remains compliant
• Communicate key risks and audit results to all levels of leadership to drive awareness and/ or organizational change
• Train, coach and support staff on quality and compliance procedures to drive team performance
• Facilitation of all compliance efforts to maintain contractual regulations
• Other 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

MINIMUM QUALIFICATIONS

• Bachelor’s degree in Public Policy or other related field or equivalent years of experience
• 3 years’ experience with Medicaid, State and Federal funding regulations
• Knowledge and experience conducting Medicaid audits, review of legal documents, and regulation analysis
• Skilled in the use of process improvement tools and methodologies
• Skilled in managing multi-faceted projects across multidisciplinary teams in organized and cost effective manners, using Project management techniques, tools and the model for improvement framework
• Knowledge of statistics, data collection, analysis, and data presentation
• Excellent interpersonal communication and problem-solving skills
• Knowledge of federal and state laws and regulations, and accreditation standards
• Proven success interacting with customers, peers, senior management and other functional areas to assure the best quality systems are in place and being adhered

Acumen is an Equal Employment Opportunity (EEO) employer. We embrace diversity in all its form. We provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. 

If you require reasonable accommodation for any part of the application process or hiring process, please submit your request through one of the following methods listed below:

(a) Dedicated fax 866-268-8885
(b) Dedicated email hrdept@riseservicesinc.org DISABILITY ACCOMMODATION REQUESTS ONLY
(c) US mail - 4554 E Inverness Ave Mesa, AZ 85206- Attn Human Resources
(d) Dedicated phone – 1-866-242-2714 Option 1 (Employment Opportunities) DISABILITY ACCOMMODATION REQUESTS ONLY