Quality & Compliance Lead: Audits, Medicaid & Improvement

Acumen Fiscal Agent; Phoenix (AZ); On-site; USD 70,000 - 100,000; Full time

Job summary

Acumen Fiscal Agent is seeking a Quality and Compliance Specialist to support day-to-day quality and compliance operations, monitor regulatory requirements, and promote continuous improvement across programs. This role emphasizes audits, corrective action planning, reporting, and staff support to uphold a culture of accountability and operational excellence.

Ideal candidates will demonstrate strong analytical, organizational, and leadership skills, with the ability to manage multiple priorities

Qualifications

• Bachelor’s degree in a related field or equivalent combination of education and experience.
• Minimum of 2 years of experience in quality compliance, auditing, healthcare administration, Medicaid programs, or related field.
• Experience coordinating audits, compliance reviews, corrective action plans, or regulatory reporting activities.
• 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 Acumen-specific systems and programs.
• Valid driver’s license within state of residence and valid automobile insurance.

Responsibilities

• 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 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.

Skills

Quality Assurance

Regulatory Compliance

Auditing

Data Analysis

Project Management

Communication

Attention to Detail

Confidentiality

Education

Bachelor’s degree in public policy, Social Sciences, Business Administration, Healthcare Administration, or related field

Tools

Microsoft Office

Job description

Acumen Fiscal Agent is seeking a Quality and Compliance Specialist to support day-to-day quality and compliance operations, monitor regulatory requirements, and promote continuous improvement across programs. This role emphasizes audits, corrective action planning, reporting, and staff support to uphold a culture of accountability and operational excellence.

Ideal candidates will demonstrate strong analytical, organizational, and leadership skills, with the ability to manage multiple priorities