State Adherence Specialist I

Started in 2016, FreedomCare is a Healthcare company that is innovating and revolutionizing the way home care is delivered. We bring dignity and support to patients needing care in their homes and to the caregivers who care for them. We’re the largest consumer-directed home care agency in NY State and are continually expanding our areas of focus including operations in other states and tech-based innovations.  

We pride ourselves on our values which drive the level of care that we deliver to our patients:

• Here For You (An attitude of service, empathy, and availability)
• Own It (Drive and ownership)
• Do the Right Thing (High integrity)
• Be Positive (Great attitude and a can-do positive approach to challenges)

Join our team and make a positive impact on the lives of others! We are looking for a State Adherence Specialist I for our team in Georgia.

This is a Hybrid role, 3 days in our Douglasville, GA office and 2 days remote, Monday through Friday 9AM to 6PM Eastern Time. 

Department & Position Overview:

The State Adherence Specialist I supports continuous administrative compliance across FreedomCare's active Georgia Elderly and Disabled Waiver Program (EDWP) Structured Family Care (SFC) member and caregiver population. This role monitors assigned cases throughout the Pre-Care and On-Care lifecycle by verifying that enrollment documentation, onboarding activities, and ongoing requirements remain complete, accurate, timely, and aligned with Georgia Department of Community Health (DCH), Georgia Medicaid, EDWP, CCSP/SOURCE, federal, payer, program, and company requirements.

Rather than functioning as a one-time quality checkpoint, the State Adherence Specialist I maintains ongoing administrative audit readiness by identifying compliance risks, partnering with Operations and appropriate internal leadership to resolve deficiencies, and confirming that assigned cases continue to meet program requirements throughout the duration of care.

This role is responsible for administrative compliance monitoring and auditing. Clinical review, clinical assessment, and clinical decision-making remain the responsibility of the RN clinical team.

Using established procedures, regulatory guidance, and standardized workflows, this individual maintains accurate, audit-ready documentation while exercising sound judgment, attention to detail, and a commitment to operational excellence.

Every Day You Will:

• Own the administrative compliance monitoring of assigned member and caregiver cases throughout the Pre-Care and On-Care lifecycle, coordinating operational and regulatory escalations with the appropriate internal leaders.
• Validate SFC authorization and member and caregiver eligibility, including required background and registry screenings, qualifying relationship and co-residence, and other onboarding documentation required by Georgia EDWP/SFC policy or company standards.
• Review and maintain enrollment and ongoing compliance documentation, monitor time-sensitive requirements—including required contacts and in-home visits, caregiver training and coaching plans, CPR certification, competency examinations, and annual renewals—and coordinate timely correction of identified deficiencies.
• Verify that current emergency and backup-care plans are maintained and coordinated with the member, caregiver, and case management agency.
• Audit member, caregiver, and incident records to confirm required documentation, escalation, investigation, reporting, record accessibility, and corrective actions are completed; support internal and external audits as needed.
• Monitor administrative compliance with HCBS requirements, member rights, HIPAA, organizational privacy standards, and applicable DCH, Georgia Medicaid, EDWP, SFC, payer, and company requirements.
• Provide compliance guidance, research and escalate complex regulatory questions, remain current on applicable program changes, and recommend improvements to compliance workflows and documentation quality.

Ideal Candidate Will Possess:

• Demonstrates FreedomCare's Core Values by consistently doing the right thing, maintaining a positive attitude, acting with integrity, and delivering exceptional service.
• High integrity and commitment to ethical decision-making.
• Exceptional attention to detail and organizational skills.
• Ability to interpret and consistently apply policies, procedures, program requirements, and regulatory guidance to identify administrative compliance risks, documentation deficiencies, overdue requirements, and potential incident-reporting gaps.
• Ability to manage competing priorities and collaborate across Operations, Compliance, the RN clinical team, internal leadership, and other cross-functional teams to coordinate appropriate non-clinical escalations and complete corrective actions.
• Comfortable learning new regulations, technology platforms, and operational processes.
• Proficiency with Microsoft Office, Google Workspace, Salesforce, and electronic document management systems preferred.
• Bilingual in Spanish or another language is a plus.
• Demonstrates accountability, professionalism, adaptability, and continuous learning.
• Maintains strict adherence to HIPAA, organizational confidentiality standards, and regulatory requirements.

Nice-to-Haves:   

• Associate's degree preferred; equivalent work experience considered.
• 0–2 years of experience in healthcare operations, compliance, onboarding, quality assurance, medical records, or related administrative functions.
• Experience working in a regulated healthcare environment preferred.
• Experience using Salesforce, CRM platforms, electronic document management systems, or workforce technology preferred.
• Experience reviewing confidential records and maintaining audit-ready documentation preferred.
• Working knowledge of Georgia Medicaid, EDWP, CCSP/SOURCE, SFC, and HCBS requirements preferred, or the ability to complete required program training within the established onboarding period.
• Experience monitoring high-volume compliance deadlines, identifying deficiencies, and coordinating corrective actions preferred.

Why work at FreedomCare?

Benefits include:

• Medical, dental, and vision insurance
• Life insurance
• Short-term and long-term disability insurance
• 401(k) with company match
• Continuing education and professional development opportunities
• Opportunities for career growth
• Wellness programs
• Gym reimbursement
• Internet reimbursement
• Competitive compensation
• Technology and tools designed to support communication, documentation, and care coordination

This is a place where your voice matters, where we build great relationships, and your work has meaning and a tangible positive impact on others!

At FreedomCare, we celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based upon race, religion, color, national origin, ancestry, age, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.