[Hiring] EAP Compliance and Quality Program Coordinator @LanguageLine Solutions

Role Description

We are seeking a Compliance & Quality Program Coordinator to support regulatory compliance, grievance administration, quality improvement initiatives, and accreditation activities within our Employee Assistance Program (EAP). This role is ideal for a detail-oriented professional who enjoys solving complex problems, managing regulatory processes, and partnering across teams to improve quality and compliance outcomes.

What You'll Do

• Maintain regulatory compliance, support audit readiness, oversee grievance processes, and coordinate quality improvement activities.
• Work closely with clinical leadership, operations, legal counsel, and other stakeholders to identify risks, ensure regulatory adherence, and drive continuous improvement.

Key Responsibilities

• Regulatory Compliance & Audit Readiness
  • Coordinate regulatory reporting, documentation, filing requirements, and compliance calendars associated with the Knox-Keene license.
  • Monitor regulatory and legislative updates and communicate impacts to leadership and key stakeholders.
  • Support audit readiness efforts, including documentation collection, evidence preparation, and regulatory follow-up activities.
  • Maintain accurate records of filings, inquiries, corrective actions, and regulatory commitments.
  • Identify potential compliance risks and recommend appropriate actions or escalations.
• Grievance Administration & Resolution
  • Monitor grievances from intake through closure, ensuring accurate tracking, documentation, investigation, and timely resolution.
  • Conduct investigations and manage non-clinical grievance communications.
  • Collaborate with clinical leadership on grievances requiring clinical review.
  • Prepare compliant grievance correspondence and maintain complete case documentation.
  • Analyze grievance trends and recommend process improvements, training opportunities, and corrective actions.
• Compliance & Quality Program Coordination
  • Coordinate day-to-day activities supporting compliance, grievance, and quality programs.
  • Maintain workplans, dashboards, tracking tools, action-item logs, and regulatory calendars.
  • Monitor deadlines, dependencies, and potential risks while escalating concerns as needed.
  • Prepare materials and documentation for compliance and quality meetings.
  • Provide leadership with updates regarding compliance activities, grievance trends, and quality initiatives.
• Cross-Functional Collaboration & Training
  • Serve as a liaison among clinical leadership, operational teams, legal counsel, Provider Relations, and other stakeholders.
  • Partner with teams to improve reporting processes, documentation standards, and workflow efficiency.
  • Assist with training and education related to compliance, audit, grievance, and reporting requirements.
  • Support accreditation and compliance initiatives across multiple business areas as needed.
• Quality Improvement
  • Analyze compliance, grievance, and service-related data to identify trends and opportunities for improvement.
  • Support root cause analysis activities and track corrective and preventive actions through completion.
  • Monitor improvement initiatives and communicate progress, outcomes, and risks to leadership.
  • Contribute to ongoing efforts that improve member experience, service quality, and regulatory readiness.

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 3+ years of experience in healthcare compliance, regulated healthcare operations, grievance administration, quality improvement, accreditation support, licensing, or a related field.
• Experience coordinating investigations, grievances, audit readiness activities, or corrective action processes.
• Strong organizational and project management skills with the ability to manage multiple priorities and deadlines.
• Excellent written and verbal communication skills.
• Proficiency with business technology and reporting tools such as Excel, Salesforce, case management systems, or similar platforms.
• Ability to exercise sound judgment, maintain confidentiality, and work independently.

Preferred Qualifications

• Familiarity with the Knox-Keene Health Care Service Plan Act, DMHC requirements, CMS programs, Medicare, Medicaid managed care, or similar regulatory frameworks.
• Experience supporting regulatory filings, accreditation reviews, audits, or ongoing compliance readiness efforts.
• Experience investigating or managing healthcare grievances, service complaints, or quality concerns.
• Knowledge of quality improvement methodologies, root cause analysis, and corrective action planning.
• Experience improving operational processes to enhance compliance, efficiency, and consistency.

Success in This Role

• Strong attention to detail
• Critical thinking and analytical skills
• Excellent project and time management
• Ability to influence and collaborate across teams
• Effective written and verbal communication
• Adaptability in a fast-paced, highly regulated environment

Physical Requirements

• This position is primarily sedentary, requiring prolonged sitting while performing administrative tasks.
• The role involves extensive use of a computer for typing, mouse navigation, and reading information on a screen for extended periods.
• Frequent phone use is required for communication with team members, clients, or external parties.
• Essential physical functions include fingering, grasping, pulling hand-over-hand, and repetitive motions necessary for navigating software, entering data, and interacting with electronic documents.

Mental and Cognitive Requirements

• The role requires strong concentration, attention to detail, and the ability to complete tasks accurately.
• Critical thinking and problem-solving skills are essential to address issues that may arise in day-to-day duties.
• Effective verbal and written communication skills are needed for responding to inquiries and collaborating with others.

Work Environment

• This position is fully remote and requires a home office environment with appropriate lighting, a computer, and phone access.
• The workspace should be free from distractions to ensure effective focus and productivity during work hours.