Quality and Compliance Supervisor

Position Summary

The Quality and Compliance Supervisor will support the organization’s quality assurance and compliance initiatives by supervising day-to-day quality and compliance operations, monitoring contractual and regulatory requirements, and supporting continuous improvement efforts across programs and departments. This role serves as a liaison between Quality and Compliance leadership, Operations teams, and Program leadership to ensure organizational adherence to Medicaid, State, Federal, and contractual requirements.

The Quality and Compliance Supervisor is responsible for overseeing audits, investigations, corrective action planning, reporting, staff support, and compliance tracking activities while promoting a culture of accountability, quality improvement, and operational excellence. This position requires strong analytical, organizational, project management, and leadership skills, as well as the ability to manage multiple priorities in a fast-paced environment.

Role And Essential Functions

• Supervise and support Quality and Compliance team members in daily operations, workload management, and professional development
• Conduct routine coaching and performance evaluations with staff
• Support corrective action plans and development planning with staff
• Assist with onboarding and training team members
• Establish clear expectations and ensure adherence to the score card measurements
• Maintain detailed understanding of all current AFA contracts, provider manuals, policies, and applicable State and Federal regulations
• Serve as a subject matter resource regarding contract compliance, program requirements, and quality assurance processes
• Act as a liaison between Program Managers, Executive Directors, Operations teams, and other departments to resolve compliance concerns, contractual issues, audit findings, and operational risks
• Assist with the implementation and oversight of quality assurance and compliance programs, systems, and initiatives across the organization
• Coordinate and oversee internal and external audits, Requests for Information (RFI), subpoenas, surveys, and regulatory reviews
• Facilitate cross-department collaboration to compile accurate and timely audit documentation while maintaining compliance with HIPAA and contractual requirements
• Review audit findings, identify trends and risks, and provide recommendations to leadership to support quality improvement initiatives
• Monitor and oversee complaint tracking, investigations, trending analysis, and escalation processes
• Support departments in developing and implementing corrective and preventative action plans to resolve compliance and quality concerns
• Research, analyze, and communicate changes in legislation, regulations, contracts, and program requirements that may impact operations or organizational compliance
• Assist in the development, implementation, and maintenance of policies, procedures, forms, reporting tools, and internal controls to support compliance objectives
• Develop and maintain reports, metrics, dashboards, and tracking systems to measure organizational performance and compliance outcomes
• Lead or support quality improvement initiatives utilizing structured problem-solving and process improvement methodologies
• Assist with the development and delivery of staff trainings related to quality assurance, compliance requirements, audits, and contractual obligations
• Monitor completion of required trainings and compliance activities to ensure contractual and regulatory standards are met
• Communicate key risks, audit results, and compliance concerns to leadership to support informed decision-making and operational improvements
• Independently manage and prioritize multiple projects and assignments while meeting strict deadlines
• Occasionally work evenings or weekends as needed to support audits, deadlines, or high-volume demands
• Perform other work-related duties as assigned

QUALIFICATIONS

Minimum Qualifications

• Bachelor’s degree in public policy, Social Sciences, Business Administration, Healthcare Administration, or related field; or equivalent combination of education and experience
• Minimum of 2 years of experience in quality assurance, compliance, auditing, healthcare administration, Medicaid programs, or related field
• Previous experience coordinating audits, compliance reviews, corrective action plans, or regulatory reporting activities
• Demonstrated leadership, supervisory, or team lead experience preferred
• Knowledge of Medicaid, State, and Federal regulations and contractual compliance requirements
• Strong project management, organizational, analytical, and problem-solving skills
• Ability to manage multiple priorities and deadlines with limited supervision
• Excellent written and verbal communication skills
• Strong attention to detail and ability to maintain confidentiality
• Experience using Microsoft Office applications including Word, Excel, Outlook, and PowerPoint
• Ability to learn and become proficient in all Acumen-specific systems and programs
• Valid driver’s license within state of residence and valid automobile insurance

Preferred Qualifications

• Experience conducting Medicaid audits and regulatory reviews
• Experience with quality improvement methodologies and process improvement tools
• Knowledge of HIPAA requirements and healthcare compliance standards
• Experience analyzing data, identifying trends, and presenting findings to leadership
• Experience developing or facilitating staff training programs
• Previous experience in social services, healthcare operations, or managed care environments

Communication Skills

• Excellent communication and relationship skills with all stakeholders, including clients, state entities, and colleagues
• Ability to effectively and respectfully interact with client base that has varying levels of ability, educational backgrounds, authority, and ethnicities
• Ability to maintain confidentiality