Compliance Specialist

The Compliance Specialist at Covenant Case Management Services is responsible for overseeing regulatory compliance, quality assurance, documentation integrity, and internal systems in alignment with NC Medicaid, DHHS, MCO requirements, HIPAA, CARF standards, and internal policies. This role works collaboratively with leadership, intake, quality management, human resources, and clinical staff to ensure ongoing compliance, accurate data tracking, and continuous quality improvement across services.

Key Responsibilities

Compliance & Documentation

• Maintain and update organizational forms to ensure current and compliant versions are in use.
• Sign Individual Support Plans in accordance with regulatory and organizational requirements.
• Ensure NCTracks provider information is accurate and updated as required.
• Monitor incident reporting training and compliance for new employees.
• Supervise the Medical Records Coordinator to ensure compliance, organization, and readiness for audits or reviews.

Policy Development & Quality Management

• Collaborate with CQO and leadership on the creation, revision, and maintenance of organizational policies, procedures, and program handbooks.
• Participate in and support Quarterly Chart Audits alongside the Quality Management team.
• Attend and actively participate in Human Rights Committee meetings.
• Support ongoing quality improvement initiatives related to compliance findings.

Data Management & Tracking

• Work across teams to track admissions, discharges, and related service data.
• Maintain accurate and up-to-date compliance, intake, discharge, and quality-related spreadsheets.
• Ensure data integrity and timely reporting for internal and external compliance needs.
• Review and circulate critical communications received from Managed Care Organizations (MCOs).

Training & Support

• Train new employees on Incident Reporting (IR) processes, compliance expectations, and documentation standards.
• Serve as a compliance resource for staff, providing guidance and clarification on policies, procedures, and regulatory requirements.

Qualifications

• Bachelor’s degree in Human Services, Healthcare Administration, Business Administration, or a related field (required).
• Experience with NC Medicaid, NC Innovations Waiver, or similar Medicaid-funded services strongly preferred.
• Knowledge of NCTracks, documentation standards, and compliance regulations.
• Strong attention to detail, organization, and analytical skills.
• Proficiency in Microsoft Office (Excel, Word) and electronic documentation systems.
• Ability to collaborate effectively across departments and communicate clearly with staff at all levels.

Preferred Skills & Attributes

• Experience in Quality Management, Compliance, or Regulatory Oversight.
• Familiarity with CARF standards or accreditation processes.
• Ability to manage multiple priorities and deadlines.
• Strong ethical standards and commitment to person-centered services.
• Qualified Professional status.

Work Environment

This position may involve a combination of office-based and remote work, with periodic travel for meetings, audits, or site visits as required.

Equal Employment Opportunity Statement

Covenant Case Management Services actively encourages applications from individuals of all backgrounds and lived experiences. We believe diversity strengthens our ability to serve individuals and families with dignity, respect, and compassion.

Covenant Case Management Services is an Equal Employment Opportunity employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, marital status, or any other protected characteristic under applicable federal, state, or local laws.

We are committed to providing a workplace free from discrimination and harassment and to fostering a diverse, inclusive, and respectful environment for all employees, contractors, and applicants. Employment decisions are based on qualifications, merit, and business needs.