Compliance Specialist jobs in Beaumont, TX

Position Summary

The Quality and Compliance Specialist promotes a culture of improvement within the Texas Family Care Network by monitoring the quality and regulatory compliance of network providers and providers from whom ancillary services are purchased. The Quality and Compliance Specialist will be responsible for facilitating the provider monitoring process, including routine provider audits, site visits, and partnering with network providers to develop and implement performance improvement plans and tracks results to ensure all issues are remediated. The Quality and Compliance Specialist will perform all job duties in a way that demonstrates and emphasizes kind and respectful behavior, purposeful connection, and integrity in a service-oriented manner.

Essential Roles and Responsibilities

1. Review applications from prospective Network Providers, required documents, policies, and forms. Conducts due diligence screening for performance and compliance history of prospective provider, uploads documentation into the organization's system, and submits all documents to the state for review and approval.
2. Conducts audits, reviews, on-site visits, and monitoring of assigned network providers according to the terms of their contract.
3. Facilitates joint monitoring process with other SSCCs as applicable
4. Develops performance improvement plans for network providers
5. Conducts investigations of serious incidents, grievances, and complaints as needed
6. Performs all duties within contract, state and federal regulations and company policies

Essential Qualifications

1. Valid driver’s license and auto insurance.
2. Clearances. State Police, FBI, and Child Abuse Clearances; CPSL Mandated Reporter- Recognizing and Reporting Child Abuse training per state regulation.

Working Conditions

1. Physical Demands. Requires vision, speech, and hearing. Position allows employee to move about freely or sit at will when performing job duties.
2. Environmental Factors. Office environment.
3. Working Hours. Traditional 40-hour work week.