Contract Compliance, Audit, & Reporting Specialist

Easterseals MORC•Auburn Hills, MI

2d•Onsite

About The Position

Easterseals MORC is seeking a Contract Compliance, Audit, & Reporting Specialist to monitor contracted service provider and funder requirements for compliance, including Certified Community Behavioral Health Clinic (CCBHC) Designated Collaborating Organizations (DCO’s) and other contracted service provider requirements. This role leads audit and reporting activities to monitor compliance with requirements, metric expectations, corrective actions, and compliance across DCO and contracted network providers. The position collaborates closely with Contract Management, Quality Assurance, Program Leadership, Corporate Compliance, and contracted network providers and partners to ensure required standards are met and sustained. This position serves as a liaison between the organization and contracted network providers, supporting effective oversight, communication, and continuous quality improvement. This role also ensures timely monitoring, documentation, reporting, and follow-up related to provider performance, contract requirements, and compliance expectations.

Requirements

Monitoring contracted service provider and funder requirements for compliance.
Leading audit and reporting activities to monitor compliance with requirements, metric expectations, corrective actions, and compliance across DCO and contracted network providers.
Collaborating with Contract Management, Quality Assurance, Program Leadership, Corporate Compliance, and contracted network providers and partners.
Serving as a liaison between the organization and contracted network providers.
Ensuring timely monitoring, documentation, reporting, and follow-up related to provider performance, contract requirements, and compliance expectations.
Creating and maintaining the audit schedule, tracking deadlines, organizing records, assigning follow-up tasks, and ensuring audits are completed on time and documented consistently.
Conducting periodic audits, credentialing audits, and administrative/desk audits.
Monitoring training compliance for contracted service providers.
Monitoring attestations.
Verifying policy and procedure compliance for contracted service providers.
Supporting activities related to MiChoice funder and regulatory reporting.
Collaborating with the Reporting and Business Intelligence (RBI) Team to develop management reports and monitoring tools.
Conducting FWA (Fraud, Waste, and Abuse) monitoring.
Conducting conflict monitoring.
Following up on Contracted Service Provider PIP/CAP (Performance Improvement Plans/Corrective Action Plans).
Monitoring CCBHC DCO (Certified Community Behavioral Health Clinic Designated Collaborating Organizations) compliance.
Ensuring quality alignment between auditing and compliance activities and broader quality goals.
Reporting findings, trends, risks, and follow-up actions to Corporate Compliance.
Providing quarterly performance updates to Leadership.

Responsibilities

Audit administration: creating and maintaining the audit schedule, tracking deadlines, organizing records, assigning follow-up tasks, and ensuring audits are completed on time and documented consistently. Maintaining a clear record of findings, corrections, and re-review dates.
Periodic audits: conducting scheduled reviews at regular intervals to confirm that contracted service provider programs, including required processes and procedures, are meeting required standards.
Credentialing audits: verifying that contracted service providers meet required qualifications, licenses, certifications, training, and enrollment standards, and checking that documentation is complete, current, and aligned with funder and regulatory expectations.
Administrative May audits (Desk audits): conducting document-based reviews to examine records, reports, attestations, and other evidence to determine whether a contracted service provider is meeting expectations.
Training compliance monitoring: ensuring required trainings are completed, tracked, and kept up to date for contracted service providers, including orientations, annual refreshers, evidence-based practice training, safety-related training, and funder-specific education.
Attestations: ensuring attestations are collected on time, completed properly, and supported by documentation when needed.
Policy and procedure compliance: verifying that contracted service providers are following contract requirements, including policies and procedures, reviewing and ensuring that practices match written standards, compliance with updates, and correct use of processes in day-to-day work. Coordinating education, corrective action, and follow-up when gaps are identified.
MiChoice and other regulatory reporting: supporting activities related to MiChoice funder and regulatory requirements.
Collaborating with the Reporting and Business Intelligence (RBI) Team to develop management reports and monitoring tools for Easterseals MORC and contracted service providers to identify and report problems related to authorization accuracy, diagnosis coding, and related documentation concerns.
FWA monitoring (Fraud, waste, and abuse): monitoring DCO and Provider Network to identify patterns or behaviors that could create legal, financial, or ethical risk, such as billing irregularities, improper documentation, duplicate services, or suspicious referral patterns.
Conflict monitoring: identifying situations that could create conflicts of interest, referral concerns, self-dealing, or other relationship-based risks.
Contracted Service Provider PIP/CAP follow-up: reviewing and following up on Performance Improvement Plans and Corrective Action Plans, tracking remediation of concerns/issues, ensuring deadlines are met, and that identified issues are effectively addressed and not recurring.
CCBHC DCO Compliance Monitoring: ensuring that Certified Community Behavioral Health Clinic DCO requirements are met, including required training, evidence-based practice, credentialing, and staffing expectations.
Quality alignment: ensuring that contracted service provider auditing and compliance activities align with broader quality goals and expectations, and that findings inform quality improvement, service enhancements, and leadership priorities.
Reporting to Corporate Compliance: sharing findings, trends, risks, and follow-up actions with the Corporate Compliance team.
Providing quarterly performance updates to Leadership regarding monitoring efforts, trends, compliance issues, and areas of improvement.

Benefits

Low-cost Dental/Health/Vision insurance
Dependent care reimbursement
Up to 5 days paid FMLA for maternity, paternity, foster care and adoption
Generous 401K retirement plan
Paid Leave Options Available
Up to $125 bonus for taking 5 days off in a row
10 paid holidays and 3 floating holidays (Over 30 days total of paid time off)
Wellness Programs
PSLF (Public Service Loan Forgiveness) Employer
Bonuses and extra incentives to reward hard work & dedication
Mileage reimbursement in accordance with IRS rate
Free financial planning services through our partnerships with the LoVasco Consulting Group, and SoFi
Student loan repayment options
Pet Insurance