Development Specialist

WESTMORELAND CASEMANAGEMENT AND SUPPORTS INC•Hempfield Township, PA

6d•Hybrid

About The Position

This full-time, exempt position supports agency-wide compliance, quality improvement, performance measurement, service development, strategic initiatives, and grants. Working with the Quality/Compliance Development Supervisor and Quality/Compliance Director, the specialist maintains compliance integrity, improves service quality and efficiency, identifies risks and opportunities, and supports responsible growth and innovation. The role requires strict confidentiality and supports Targeted Case Management, Targeted Support Management, County Funded Programs, and other funded services. The standard schedule is Monday through Friday, 8:30 a.m. to 4:30 p.m., with a 30-minute lunch, totaling 37.5 hours weekly, unless otherwise agreed. Work is primarily performed in a standard office environment, though work location may change with operational needs. Remote work may be approved depending on workload and office coverage; a hybrid schedule may be offered after successful completion of the introductory period. Work outside the office or remote environment, including overnight travel, may be required. The specialist supports regulatory and agency compliance; audits and monitoring; corrective-action tracking; quality improvement and incident review; performance measurement and data analysis; policy and accreditation documentation; service development and grants; and training and cross-department collaboration. The position requires adherence to applicable WCSI, County, State, Federal, HIPAA, and program requirements, as well as confidentiality, sound judgment, accuracy, and effective organization of time-sensitive work.

Requirements

Bachelor’s degree (BA/BS) and three years of professional experience, including experience in social services, compliance, quality assurance, program operations, data analysis, or a related field; or an equivalent combination of education, experience, and training demonstrating the required knowledge, skills, and abilities.
Knowledge of compliance and quality principles, regulatory interpretation, audit practices, corrective-action monitoring, risk identification, and continuous quality improvement.
Ability to read and interpret complex written requirements, synthesize information, ask pertinent questions, exercise sound judgment, and form supportive conclusions.
Strong analytical, organizational, project-management, report-writing, presentation, and interpersonal skills.
Ability to communicate clearly verbally and in writing, maintain sensitive records, manage frequent interruptions, and prioritize multiple responsibilities and deadlines.
Ability to work independently and collaboratively while demonstrating integrity, accountability, respect, innovation, and attention to detail.
Valid Pennsylvania driver’s license and proof of valid auto insurance.
Act 34 Criminal Record clearance, Act 33 Child Abuse clearance, and FBI clearance.
Monthly screenings of the PA Medicheck List, LEIE (List of Excluded Individuals/Entities), and SAM (System for Award Management).
Ability to perform the essential functions of the job, with reasonable accommodations where applicable.
Adherence to applicable HIPAA privacy and security standards and WCSI random drug screening requirements.

Nice To Haves

Direct experience with regulatory compliance, internal auditing, quality improvement, accreditation, or human-services programs.

Responsibilities

Stay current on federal, state, county, managed care, contractual, HIPAA, and program-specific requirements affecting WCSI services.
Support the Quality/Compliance Plan, Whistleblower Policy, and related compliance processes.
Assist with internal reviews, external audits, monitoring visits, investigations, revalidations, re-credentialing, and required regulatory submissions.
Complete ODP certified investigator training to assist with agency investigative reviews as required.
Develop and maintain program-based audit tools; conduct scheduled and focused audits; compile evidence, document findings, and prepare reports.
Recommend and track corrective actions and process improvements, conduct follow-up reviews, and report unresolved or critical issues to leadership.
Assess regulatory and legislative updates for operational impact and communicate relevant changes to affected departments.
Maintain confidential compliance records and support conflict-of-interest reviews and risk management.
Support continuous quality improvement and help departments turn findings into measurable improvement plans.
Monitor quality indicators, incidents, documentation errors, provider paybacks, satisfaction results, and other performance measures for trends, risks, and improvement opportunities.
Support incident reviews, root cause analysis, after-action recommendations, and closure monitoring.
Help develop and review audit methodologies, quality standards, surveys, and monitoring tools annually.
Coordinate or support Compliance Committee and subcommittee agendas, materials, minutes, confidentiality agreements, bylaws, and follow-up.
Provide technical assistance and training promoting compliance, accountability, and continuous improvement.
Develop and maintain tracking for audits, incident management, quality reviews, satisfaction surveys, corrective actions, provider paybacks, accreditation, and assigned initiatives.
Compile, organize, calculate, tabulate, validate, audit, and analyze information while preserving data integrity.
Prepare dashboards, summaries, audit and corrective-action reports, and other written presentations for leadership and stakeholders.
Identify trends, emerging risks, service gaps, and opportunities, and recommend data-informed actions.
Collaborate with programs and administrative staff to improve data collection, reporting consistency, and performance measurement.
Help draft, review, revise, and maintain compliance, quality, and agency operations policies and procedures.
Support PANO Standards for Excellence accreditation and maintain required accreditation and monitoring documentation as needed.
Coordinate and maintain assigned Medical Assistance initial enrollment and revalidation documentation under Quality/Compliance Development Supervisor oversight.
Research community needs, service gaps, quality-management practices, and emerging trends to support new or improved services.
Support feasibility reviews, outcome monitoring, and sustainability assessments for strategic initiatives.
Help research funding opportunities and contribute to assigned grant applications, narratives, supporting data, project tracking, and required outcome reports.
Develop and deliver orientation and training on compliance, quality, policies, processes, reviews, accreditation, and assigned regulatory topics.
Build constructive cross-department relationships and communicate effectively in meetings, email, reports, presentations, and training.
Use Microsoft Word, Excel, PowerPoint, databases, and other systems to organize work, analyze information, and communicate results.
Organize assignments, set goals and timelines, balance priorities, and complete time-sensitive work using sound judgment.
Attend required meetings and training, and support agency initiatives, project management, and special assignments.
Demonstrate professional judgment, confidentiality, accuracy, teamwork, and forward-thinking problem solving.
Perform other position-related duties assigned by the Quality Compliance Development Supervisor, Quality/Compliance Director, Chief Administrative Officer, or Chief Executive Officer.
Adhere to applicable WCSI, County, State, and Federal guidelines, regulations, policies, and laws, including HIPAA privacy and security standards.
Comply with WCSI random drug screening requirements and complete a WCSI Time Study when required for funding allocation.