Quality and Regulatory Affairs Specialist - LIFE/PACE - FT - Day

Capital Health (US); Tennessee; On-site; USD 61,000 - 80,000; Full time

Benefits offered by this job

Medical Plan

Dental Plan

Vision Plan

FSA

Retirement Savings and Investment Plan

Life Insurance

AD&D Insurance

Long Term Disability

Short Term Disability

Employee Assistance Program

Commuter Transit

Commuter Parking

Paid Time-Off

Job summary

Capital Health is seeking a Quality and Regulatory Affairs Specialist – PACE to support the Quality and Regulatory Affairs Manager in implementing and maintaining compliance and continuous quality improvement across the PACE program. The role involves data collection, audit preparation, internal reviews, and liaising with EMR vendors for regulatory updates and system optimization.

Responsibilities include developing dashboards and CMS universe reports, coordinating data for quality initiatives,

Qualifications

• Bachelor's degree in a related field required.
• At least 1 year of healthcare quality, compliance, or regulatory support experience.
• Strong data collection, auditing and documentation skills.

Responsibilities

• Develop and maintain compliance logs and dashboards.
• Prepare CMS universe reports for external audits.
• Coordinate data for quality improvement initiatives and metrics.
• Track corrective actions from audits and reviews.
• Assist with policy adherence monitoring and record documentation.
• Support EMR vendors and IT teams on data integrity and reporting.

Skills

Data collection

Quality metrics

Audit support

Regulatory compliance

Cross-functional coordination

Education

Bachelor's degree

Tools

EMR systems

CMS reporting

Job description

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range

$60,881.60 - $79,560.00

Scheduled Weekly Hours

40

Position Overview

The Quality and Regulatory Affairs Specialist – PACE supports the Quality and Regulatory Affairs Manager in implementing and maintaining compliance and quality improvement activities across the PACE program. This role is responsible for collecting and organizing data, supporting audit preparation, conducting internal quality reviews, assisting with policy adherence monitoring, and ensuring timely documentation of compliance activities. The Specialist plays a key role in maintaining audit readiness and fostering a culture of regulatory and operational excellence. This position also serves as a key liaison with EMR vendors to support system optimization and regulatory updates.

Essential Functions

• Support the development, review, and maintenance of logs, dashboards, and tracking tools for compliance and quality metrics.
• Assist with preparation and validation of CMS universe reports and documentation for external audits.
• Coordinate the collection and submission of data for quality improvement initiatives and performance measures.
• Track and monitor corrective actions from audit findings and internal reviews.
• . Conduct routine internal reviews of participant records, incident reports, grievances, appeals, and service delivery documentation.
• Assist in organizing documentation for environmental and safety audits, transportation compliance, and infection control logs.
• Prepare meeting materials and assist in documentation for Quality Improvement Committee and Participant Advisory Committee.
• Support training coordination and staff communication around regulatory updates, audit findings, and compliance expectations.
• Maintain up-to-date audit readiness materials, including regulatory filing systems and policy manuals.
• Participate in audit preparation activities and serve as logistical support during audit or review visits.
• Collaborate with EMR vendors and internal IT teams to troubleshoot data integrity or reporting issues. Assist with EMR upgrades, testing and staff training related to quality functions.
• Performs other duties as assigned.

Minimum Requirements

• Education: Bachelor's degree required.
• Experience: One year experience in a healthcare quality, compliance, or regulatory support role.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• Frequent physical demands include: Pinching/fine motor activities Occasional physical demands include: Sitting, Standing, Walking, climbing (e.g., stairs or ladders), Carry objects, Push/Pull, Twisting, Bending, reaching forward, reaching overhead, Squat/kneel/crawl, Keyboard use/repetitive motion
• Continuous physical demands include: Wrist position deviation, Talk or Hear
• Lifting Floor to Waist 20 lbs. Lifting Waist Level and Above 10 lbs. Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Accurate Depth Perception, Accurate Hearing
• Anticipated Occupational Exposure Risks Include the following: N/A

This Position Is Eligible For The Following Benefits

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA)
• Healthcare FSA
• Dependent Care FSA
• Retirement Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance
• Voluntary Life Spouse
• Voluntary Life Employee
• Voluntary Life Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level.

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.