Compliance Analyst

The Compliance Analyst is responsible for overseeing and maintaining the organization’s compliance with all applicable federal, state, and local regulations governing PACE of the Triad. Responsibilities include managing the Corporate Compliance Program, detecting and preventing fraud, waste, and abuse, ensuring adherence to HIPAA, and conducting internal investigations and audits. The Compliance Analyst reports to the Director of Quality and Compliance and governing board. This position has an independent oversight role. Additionally, this position is responsible for seeking and maintaining the Provider Network for all locations.

Education/Special Training/Experience:

Bachelor’s degree in healthcare administration, law, or related fields. Minimum 3-5 years in healthcare compliance; experience in PACE, long-term care, or Medicare/Medicaid managed care preferred. Strong knowledge of CMS PACE regulations, HIPAA, and fraud prevention guidelines. Experience conducting internal investigations and managing compliance audits. Proven experience in compliance, audit, or risk management, ideally within the healthcare sector or government.

· Ability to navigate federal and state requirements simultaneously.

• Ability to identify pertinent policy issues; develop strategies, solutions, and procedures.
• Able to foster a culture of compliance, quality, and continuous improvement.
• Able to work independently and as an effective member of a team.
• Able to maintain confidentiality.

· Excellent analytical, problem-solving, attention-to-detail and follow through skills.

· Exceptional written and verbal communication, with ability to explain complex topics to diverse audiences.

· Proficiency with data analysis and reporting and visualization tools.