Compliance and Quality Director

  • Northeast Michigan Community Service Agency, Inc.
  • Gaylord, Michigan
  • Full Time
Join a mission-driven team dedicated to improving community-based care across Northeast Michigan. The Compliance & Quality Director leads our provider network strategystrengthening 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 disabilitiesdriving improvements, strengthening provider relationships, and empowering our region's long-term care network.
Job ID: 516737996
Originally Posted on: 4/9/2026

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