Renaissance Social Services
Director of Quality and Medicaid Compliance
Renaissance Social Services, Chicago, Illinois, United States, 60290
Director of Quality and Medicaid Compliance
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Director of Quality and Medicaid Compliance
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Renaissance Social Services Position Overview
Reporting to the Chief Financial Officer (CFO) with a strong partnership with the Chief Program Officer (CPO), the Director of Quality and Medicaid Compliance plays a pivotal role at Renaissance Social Services, Inc. (RSSI). This director will oversee all facets of quality assurance, compliance, and Medicaid billing integrity, ensuring the organization maintains full compliance with all regulatory requirements as well as CARF accreditation standards. The Director will drive organization-wide excellence by developing data-driven quality initiatives, strengthening compliance infrastructure, and cultivating a culture of accountability and transparency that aligns with RSSI’s mission to end homelessness and improve lives. Key Responsibilities
Medicaid Compliance and Billing Oversight: Oversee the agency’s Medicaid compliance program to ensure billing accuracy, documentation integrity, and timely reimbursement. Regulatory Monitoring: Monitor and interpret federal, state, and managed care regulations to maintain ongoing compliance. Audit Liaison: Serve as the primary liaison for Medicaid and program regulatory audits, surveys, and inspections, managing all documentation and responses. Internal Audits: Lead internal audits, manage Medicaid-related surveys or inspections, and coordinate organizational responses. Cross-Functional Collaboration: Collaborate with Finance and Program teams to align billing practices with quality and compliance goals. CARF Accreditation Leadership: Lead all CARF accreditation activities, including preparation, coordination, and follow-up, and ensure the organization remains ready to meet standards at all times. KPI Development: Develop and track key performance indicators (KPIs) that reflect service quality, compliance, and client outcomes. Policy and Procedure Management: Review, revise, develop and implement organizational policies and procedures to align with best practices and regulatory bodies. Quality Review and Data Analysis: Conduct quality reviews and analyze data to identify areas for improvement and reduce compliance and organizational risks. Performance Reporting: Analyze trends and performance data to identify opportunities for improvement and report findings to executive leadership and the Board. Continuous Improvement and Training: Partner with Program, Finance, and HR leaders to integrate quality and compliance practices across departments; oversee the utilization review process and conduct internal audits and chart reviews; provide staff training, tools and coaching at all levels to strengthen understanding of compliance, quality standards and promote accountability; gather feedback from staff, clients, and partners to guide ongoing improvement efforts. Qualifications
Bachelor’s degree in Social Services, Healthcare Administration, Public Health, or related field; LCSW is strongly preferred. Knowledge of Medicaid regulations, managed care systems, and quality improvement frameworks. Experience leading CARF or equivalent accreditation and managing compliance audits. Strong analytical, communication, and training skills, with the ability to collaborate across departments. Commitment to Renaissance’s mission, values, and organizational excellence.
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Join to apply for the
Director of Quality and Medicaid Compliance
role at
Renaissance Social Services Position Overview
Reporting to the Chief Financial Officer (CFO) with a strong partnership with the Chief Program Officer (CPO), the Director of Quality and Medicaid Compliance plays a pivotal role at Renaissance Social Services, Inc. (RSSI). This director will oversee all facets of quality assurance, compliance, and Medicaid billing integrity, ensuring the organization maintains full compliance with all regulatory requirements as well as CARF accreditation standards. The Director will drive organization-wide excellence by developing data-driven quality initiatives, strengthening compliance infrastructure, and cultivating a culture of accountability and transparency that aligns with RSSI’s mission to end homelessness and improve lives. Key Responsibilities
Medicaid Compliance and Billing Oversight: Oversee the agency’s Medicaid compliance program to ensure billing accuracy, documentation integrity, and timely reimbursement. Regulatory Monitoring: Monitor and interpret federal, state, and managed care regulations to maintain ongoing compliance. Audit Liaison: Serve as the primary liaison for Medicaid and program regulatory audits, surveys, and inspections, managing all documentation and responses. Internal Audits: Lead internal audits, manage Medicaid-related surveys or inspections, and coordinate organizational responses. Cross-Functional Collaboration: Collaborate with Finance and Program teams to align billing practices with quality and compliance goals. CARF Accreditation Leadership: Lead all CARF accreditation activities, including preparation, coordination, and follow-up, and ensure the organization remains ready to meet standards at all times. KPI Development: Develop and track key performance indicators (KPIs) that reflect service quality, compliance, and client outcomes. Policy and Procedure Management: Review, revise, develop and implement organizational policies and procedures to align with best practices and regulatory bodies. Quality Review and Data Analysis: Conduct quality reviews and analyze data to identify areas for improvement and reduce compliance and organizational risks. Performance Reporting: Analyze trends and performance data to identify opportunities for improvement and report findings to executive leadership and the Board. Continuous Improvement and Training: Partner with Program, Finance, and HR leaders to integrate quality and compliance practices across departments; oversee the utilization review process and conduct internal audits and chart reviews; provide staff training, tools and coaching at all levels to strengthen understanding of compliance, quality standards and promote accountability; gather feedback from staff, clients, and partners to guide ongoing improvement efforts. Qualifications
Bachelor’s degree in Social Services, Healthcare Administration, Public Health, or related field; LCSW is strongly preferred. Knowledge of Medicaid regulations, managed care systems, and quality improvement frameworks. Experience leading CARF or equivalent accreditation and managing compliance audits. Strong analytical, communication, and training skills, with the ability to collaborate across departments. Commitment to Renaissance’s mission, values, and organizational excellence.
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