Nature of Work: The Quality and Compliance Specialist is responsible for monitoring, supporting, and improving agency-wide quality and compliance functions. This position ensures compliance with all federal, state, and internal regulations, including Medicaid Waiver and ICF services, HIPAA, and other licensing bodies. The Specialist conducts audits and quality reviews, participates in licensing and fire safety inspections, supports accurate documentation, identifies risk trends, and ensures the agency operates in an ethical, person-centered, and legally compliant manner.
Compliance Monitoring & Quality Assurance
- Conduct internal audits of program and administrative records to ensure compliance with DHHS, OADS, CMS, HIPAA, licensing standards, and agency policies.
- Track incident reporting, documentation practices, and service delivery to identify areas of concern or non-compliance.
- Monitor documentation and records related to Individual Service Plans (ISPs), Service Implementation Plans (SIPs), and Individual Needs Assessments (INAs) to ensure completeness, accuracy, and regulatory compliance.
- Enter and maintain documentation in state and agency systems (e.g.,Evergreen, iCare Manager, Therap, Atrezzo) as required; follow up on discrepancies.
- Participate in licensing reviews, Fire Marshal inspections, and other external surveys, assisting with preparation, documentation, and follow-up actions.
- Monitor Incident reports for appropriate resolution and documentation.
- Support the agency’s HIPAA compliance efforts by maintaining confidentiality and helping identify potential privacy concerns.
Risk Identification and Reporting
- Identify and track trends in quality or compliance issues and bring concerns to the Director of Quality Improvement and Compliance.
- Assist in developing corrective action plans and ensure proper follow-up and documentation.
- Maintain systems for tracking unmet needs and service implementation progress; communicate updates to relevant teams.
Cross-Department Collaboration
- Communicate and collaborate with Residential, Shared Living, Case Management, Clinical, and Administrative staff to resolve documentation or compliance concerns.
- Act as a resource on documentation systems and quality standards.
- Participate in internal committees such as Safety, Human Rights, and Risk Management as assigned.
Documentation and Record Management
- Ensure that all compliance and quality documentation is organized, up-to-date, and securely maintained.
- Support agency readiness for audits, inspections, and external reviews through thorough and timely recordkeeping.
- Accountability: We take ownership of our actions, follow through on commitments, and hold ourselves and each other to high standards.
- Adaptability: We embrace change, stay open to feedback, and grow through learning and evolving together.
- Collaboration: We work as one team, listening, supporting, and building on each other’s strengths.
- Empowerment: We support individuals in making their own choices, fostering independence, self-expression, and valuing every voice and experience with respect and empathy.
- Community: We believe in the power of connection and community. We are dedicated to serving, placing the needs and well-being of those we support at the center of all we do.
Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time.
- Ability to work flexible hours, including occasional evenings or weekends, based on agency needs.
- Travel between agency locations as necessary.
- Maintain strict confidentiality and demonstrate a high standard of ethical and professional conduct.
- Ability to remain in a stationary position (sitting or standing) for extended periods.
- Ability to move throughout office spaces, program sites, and residential environments.
- Occasionally lift and carry items up to 35 pounds (e.g., files, laptop, audit materials).
- Must be able to use standard office equipment and electronic systems for documentation and communication.
- Associate’s or Bachelor’s degree in Human Services, Healthcare, Public Administration, or related field preferred. Equivalent combination of relevant education, training, and experience may be considered in lieu of degree.
- At least two (2) years of experience in quality assurance, compliance, or human services.
- Familiarity with HCBS, ICF, Medicaid regulations, and Maine licensing requirements.
- Proficiency with Microsoft Office and ability to learn EHR and compliance software systems (iCare Manager,Therap, Atrezzo, Evergreen , etc.).
- Strong organizational, communication, and analytical skills.
- Ability to work independently and collaboratively in a fast-paced environment.
- Ability to pass required background checks, to include: Adult/Child Protective Services; criminal history; OIG Exclusion list; National Sex Offender Registry; Bureau of Motor Vehicles record; and Maine CNA Registry.
- Ability to work flexible hours, including occasional evenings or weekends, based on agency needs.
- Travel between agency locations as necessary.
- Maintain strict confidentiality and demonstrate a high standard of ethical and professional conduct.
- Ability to remain in a stationary position (sitting or standing) for extended periods.
- Ability to move throughout office spaces, program sites, and residential environments.
- Occasionally lift and carry items up to 35 pounds (e.g., files, laptop, audit materials).
- Must be able to use standard office equipment and electronic systems for documentation and communication.
- Associate’s or Bachelor’s degree in Human Services, Healthcare, Public Administration, or related field preferred. Equivalent combination of relevant education, training, and experience may be considered in lieu of degree.
- At least two (2) years of experience in quality assurance, compliance, or human services.
- Familiarity with HCBS, ICF, Medicaid regulations, and Maine licensing requirements.
- Proficiency with Microsoft Office and ability to learn EHR and compliance software systems (iCare Manager,Therap, Atrezzo, Evergreen , etc.).
- Strong organizational, communication, and analytical skills.
- Ability to work independently and collaboratively in a fast-paced environment.
- Ability to pass required background checks, to include: Adult/Child Protective Services; criminal history; OIG Exclusion list; National Sex Offender Registry; Bureau of Motor Vehicles record; and Maine CNA Registry.
Make an Impact Where Quality Matters Most
Join 3Rivers as a Quality & Compliance Specialist and play a critical role in ensuring the highest standards of care, safety, and integrity across our services. In this dynamic role, you’ll be at the center of continuous improvement—monitoring compliance, identifying risks, and partnering with teams to strengthen systems that support individuals with intellectual and developmental disabilities.
If you’re detail-driven, collaborative, and passionate about ethical, person-centered care, this is your opportunity to turn data into action and help shape a culture of accountability, excellence, and meaningful impact.
