Compliance Specialist

Job Title: Compliance Specialist – HCBS Waiver Program
Location: Washington, DC
Reports To: Director of Quality Assurance / Program Administrator
Classification: Full-Time | Exempt

Position Summary:

The Compliance Specialist is responsible for ensuring the consistent delivery of high-quality services under the DC Home and Community-Based Services (HCBS) Waiver Program. The QA Specialist monitors, evaluates, and supports compliance with federal, state, and local regulations, particularly the Centers for Medicare & Medicaid Services (CMS) assurances, the DC Department on Disability Services (DDS), and the Department of Health Care Finance (DHCF) requirements. This role plays a key part in quality improvement initiatives and ensures individuals served receive person-centered, safe, and effective services.

Key Responsibilities:

• Conduct internal audits and file reviews to ensure compliance with HCBS waiver regulations, provider standards, and agency policies.
• Monitor and report on performance measures tied to the six CMS waiver assurances:
  1. Level of Care
  2. Service Plan
  3. Qualified Providers
  4. Health and Welfare
  5. Financial Accountability
  6. Administrative Authority
• Track critical incidents and conduct trend analysis to identify systemic issues and recommend corrective actions.
• Assist with the development and implementation of Quality Improvement Plans (QIPs).
• Review Individual Service Plans (ISPs) for accuracy, person-centeredness, and regulatory compliance.
• Participate in incident management investigations and make recommendations for preventive strategies.
• Collaborate with case managers, providers, and state agencies to address deficiencies and promote best practices.
• Provide technical assistance and training to staff and providers on quality standards, documentation, and HCBS compliance.
• Prepare and submit timely reports to management and regulatory agencies.
• Stay current with federal and local policy changes impacting HCBS and recommend updates to internal protocols accordingly.
• Assist with provider monitoring visits, surveys, and audits conducted by DDS or DHCF.

Qualifications:

• Bachelor's degree in Public Health, Social Work, Human Services, Nursing, or a related field (Master’s preferred).
• Minimum of 3 years of experience in a quality assurance, compliance, or monitoring role within human services or healthcare—preferably with HCBS or I/DD populations.
• Familiarity with CMS waiver requirements, DDS service coordination systems (e.g., MCIS), and DHCF guidelines.
• Strong analytical, organizational, and documentation skills.
• Ability to work independently and collaboratively in a fast-paced environment.
• Proficient in Microsoft Office Suite; experience with electronic health/clinical records systems.
• Excellent verbal and written communication skills.

Preferred Skills/Knowledge:

• Knowledge of the DC HCBS Waiver for Individuals with Intellectual and Developmental Disabilities (IDD Waiver).
• Experience with data analysis tools (e.g., Excel, Power BI, or Tableau).
• Familiarity with CARF or other accreditation standards.
• Experience in developing or supporting person-centered planning and service delivery.

Work Conditions:

• Primarily office-based with occasional field visits to provider sites and residential/day program locations.
• Must be able to travel within the District of Columbia.