Join a mission-driven team dedicated to improving community-based care across Northeast Michigan. The Compliance & Quality Director leads our provider network strategy—strengthening partnerships, ensuring service excellence, and safeguarding program integrity for the MI Choice Waiver and other aging services programs.
What You’ll Do:
Build & Support Our Provider Network
- Develop strong relationships with service providers and respond proactively to needs.
- Recruit, evaluate, and onboard new providers to expand long-term care options for participants.
- Lead provider communications, meetings, and collaborative quality-improvement efforts.
Lead Contracting & Program Standards
- Manage contracting processes, renewals, and compliance requirements.
- Ensure alignment with state and federal regulations, Medicaid standards, and OIG expectations.
- Oversee the self-determination program, supporting workers, fiscal intermediaries, and staff.
Monitor Quality & Performance
- Conduct provider reviews, on-site visits, billing checks, and service audits.
- Provide training and technical support to help providers meet service standards.
- Investigate issues, respond to complaints, and report findings to agency leadership.
Serve as MI Choice Waiver Compliance Officer
- Lead agency-wide compliance efforts, including training, risk assessments, and policy updates.
- Chair the Executive Compliance Committee and provide routine updates to leadership and the Board.
- Oversee the Special Investigations Unit to address fraud, waste, and abuse concerns.
- Maintain required OIG reporting and stay current on regulatory changes.
Provide Operational & Privacy Oversight
- Maintain provider databases and support staff workflows.
- Represent the agency in state meetings and internal committees.
- Serve as the HIPAA Privacy Officer, managing privacy policies and incident follow-up.
- Contribute to NCQA quality-improvement activities.
Why This Role Matters:
You’ll be at the center of ensuring safe, high-quality care for older adults and adults with disabilities—driving improvements, strengthening provider relationships, and empowering our region’s long-term care network.
Requirements
What We’ll Love About You!
We’re excited to meet someone who brings both passion and professionalism to this role—and who’s ready to help us make a meaningful impact in our Area Agency on Aging Division.
Education & Experience
- Bachelor's degree in business, Health Care Administration, Human Services, or a related field required. Master's degree in business administration, Health Care Administration, or a related discipline preferred. **Compensation based on education level and experience.**
- Prior experience as a Compliance Officer or related certification (compliance, auditing, privacy, etc.) preferred.
- Demonstrated experience in relationship development and relationship management within a comparable role or setting highly preferred.
- Knowledge of long-term care, long-term supports and services (LTTS), contracting, auditing, or other relevant areas is desired.
What You’ll Need
- Reliable transportation and a valid driver’s license—you’ll occasionally travel to events, community partners, or program sites.
- Strong communication skills: the ability to read and interpret reports, write clearly, and present information confidently.
- Solid comfort with numbers—you can handle percentages, basic calculations, and interpret data to guide your work.
- Strong problem-solving abilities, especially in situations where you need to adapt quickly or interpret information from different sources.
Professional Expectations
This role requires access to confidential information. You’ll be trusted to maintain strict privacy and confidentiality, following all NEMCSA policies and guidelines.
Physical & Work Environment Requirements
To succeed in this position, you'll need the ability to:
- Regularly sit, stand, walk, use your hands, drive, and work at a computer.
- Frequently talk and hear, and multitask in a busy environment.
- Occasionally stoop, kneel, climb, reach, or twist as needed for events or office tasks.
- Work both standard and sometimes irregular hours, meet deadlines, and interact professionally with the public and staff.
- You’ll work in a typical office setting with moderate noise levels and will often be engaged in community-based activities. Throughout employment, team members must remain free of alcohol or non-prescribed controlled substances in the workplace.
