PACE Compliance Specialist, MSW

Posted 8 Days Ago
Be an Early Applicant
02040, Greenbush, MA
71K-88K Annually
1-3 Years Experience
Fitness • Healthtech
The Role
The PACE Compliance Specialist, MSW is responsible for managing Service Delivery Requests, Appeals, and Grievances in alignment with CMS PACE Program regulations. This role includes monitoring, tracking, auditing, and partnering with interdisciplinary teams to meet the unique needs of PACE participants and their families.
Summary Generated by Built In

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

Job Overview

The PACE Compliance Specialist, MSW is responsible for the managing of all Service Delivery Requests, Appeals, and Grievances (SDAG) in alignment with the Centers for Medicare and Medicaid Services- Programs of All-Inclusive Care for the Elderly (PACE) Program federal regulations. Oversight of SDAG includes monitoring, tracking, auditing, trending aggregate data, and identifying areas for improvements. In addition, the SDAG Specialist utilizes knowledge of social systems and individual behavior interventions that meet the unique needs of PACE participants and their families to successfully resolve Grievances and process Service Delivery Requests & Appeals. The PACE Compliance Specialist, MSW partners with the PACE Interdisciplinary Teams (MSW, RN, PCP, Senior Care Advocates) in efforts to successfully manage and process Service Delivery Requests, Appeals, and Grievances within the required CMS Program requirements. This role is corporate based with participant outreach, when needed. PACE Compliance Specialist, MSW is a member if the PACE QI team and is based within corporate.
Minimum Requirements


1. Master’s Degree in Social Work (MSW) from an accredited university is required.
2. Minimum of 2 years of experience in the clinical setting required.
3. Minimum of 2 years of experience in experience in conducting internal and/or external audits is preferred.
4. Social advocacy with the geriatric population. Field work/internship may substitute 1 year of experience.
5. Bilingual: Spanish/English.
6. BLS certificate is required.

Compensation

$70,653.44 - $88,316.80 annually

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

  • Medical, Dental and Vision insurance
  • 403(b) Retirement savings plans with employer matching contributions
  • Flexible Spending Accounts
  • Commuter Flexible Spending
  • Career Advancement & Development opportunities
  • Paid Time Off & Holidays
  • Paid CME Days 
  • Malpractice insurance and tail coverage
  • Tuition Reimbursement Program
  • Corporate Employee Discounts
  • Employee Referral Bonus Program
  • Pet Care Insurance

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

The Company
HQ: Los Angeles, CA
1,832 Employees
On-site Workplace
Year Founded: 1986

What We Do

AltaMed is one of the nation’s largest community health networks. For more than 45 years, we have provided care to patients in the diverse neighborhoods of Los Angeles and Orange counties. For health care professionals committed to their patients, communities and careers, AltaMed is an excellent opportunity to pursue professional goals with pride and distinction.

AltaMed is a non-profit organization, focused on the needs of our patients and the well-being of our communities. Our commitment to community health compels us to look beyond the walls of our offices and clinics and see not just patients, but new possibilities for community wellness. We have many employees who joined us because their families were AltaMed patients and experienced firsthand that our patients are at the center of all we do.

This approach is helping us meet our ambitious goals. We are continually accredited by The Joint Commission (JCAHO), an organization that ensures quality standards in U.S. medical facilities. We’re the first community health network in the nation to have been designated as a Primary Care Medical Home (PCMH). We’re extremely proud of our achievements in patient satisfaction, with our highest scores accomplished during our period of greatest growth. We’ve expanded to 46 Southern California locations, offering primary medical, dental and senior care. We’re active in community outreach and education, and staffed by dedicated professionals committed to patient care.

Continuously looking for ways to do more for more people, AltaMed is leading the industry in bringing new people into our nation's health care system as the top enroller for Covered California. As we continue to grow, we remain at the forefront of evolving health care systems, serving patients with comprehensive care throughout their entire lives. And we will build on our reputation as a rewarding long-term decision for both patients and professionals who believe that quality health care is everyone’s right.

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