Quality and Compliance Analyst

Catholic Charities USA - New Orleans, LA

Full-time

New Orleans, LA

Religious, Grantmaking, Civic, Professional, and Similar Organizations

About the position

The Quality and Compliance Analyst is responsible for supporting the implementation and oversight of quality improvement initiatives and ensuring compliance with federal, state, and internal regulations for the PACE program. This role involves data collection, analysis, and reporting related to clinical and operational performance, working closely with the interdisciplinary team to enhance participant care quality and regulatory compliance while driving improvements in program outcomes.

Responsibilities

• Collect, analyze, and interpret data related to key quality metrics such as participant outcomes and care delivery processes.
• Assist in developing, implementing, and maintaining quality improvement programs in collaboration with clinical and operational staff.
• Conduct root cause analysis on quality concerns, identifying trends and making recommendations for corrective actions.
• Monitor performance against established benchmarks and track progress toward quality improvement goals.
• Ensure the PACE program adheres to all applicable regulations, including those outlined by CMS and state health departments.
• Conduct regular audits and reviews of compliance-related activities such as grievances and participant care documentation.
• Support the organization in preparing for state and federal audits by reviewing documentation and processes for compliance readiness.
• Maintain accurate records of quality metrics and compliance audits, producing regular reports for senior leadership and regulatory bodies.
• Develop and present data-driven reports on program performance, making evidence-based recommendations for improvements.
• Provide training to staff on quality initiatives, regulatory requirements, and best practices for compliance.
• Monitor and track participant grievances and incidents to ensure they are addressed in a timely and compliant manner.

Requirements

• Bachelor's degree in healthcare administration, nursing, public health, or a related field required.
• Minimum of 2-3 years of experience in a healthcare quality, compliance, or data analytics role, preferably within a PACE, Medicare, or managed care environment.
• Strong analytical skills with proficiency in data collection, analysis, and reporting.
• In-depth understanding of healthcare regulations, particularly CMS and state-level regulations.
• Excellent organizational and project management skills.
• Strong communication skills, both verbal and written.

Nice-to-haves

• Master's degree preferred.
• Experience with healthcare data management software (e.g., EMRs, quality management tools).