Conducts regulatory audits and surveys by planning and scheduling assigned report(s) and keeping current on regulatory requirements in preparation for surveys. Assists in facilitation of on-site visits and evaluations. Performs site visits in accordance with criteria to ensure survey readiness. Leveraging standard strategies to ensure completion of surveys, with regular review by manager. Conducts routine audits and mock surveys to aid in preparedness, tracking, trending, and aiding in the facil... more details
Description:
Job Summary:
Conducts regulatory audits and surveys by planning and scheduling assigned report(s) and keeping current on regulatory requirements in preparation for surveys. Assists in facilitation of on-site visits and evaluations. Performs site visits in accordance with criteria to ensure survey readiness. Leveraging standard strategies to ensure completion of surveys, with regular review by manager. Conducts routine audits and mock surveys to aid in preparedness, tracking, trending, and aiding in the facilitation of corrective action plans. Collaborates with others to complete annual reporting. Ensures licensing and accreditation by reviewing requirements for new, expanding, and existing facilities/services in relation to relevant accrediting standards, evaluating relevant risk and impact with limited guidance. Consults with departments to ensure certification and begins to conduct basic gap analyses for standard cases. Serves as the subject matter expert by maintaining and beginning to facilitate awareness of internal policies and consulting on the interpretation and interaction of current policies, and how they interact with the current climate, and potential changes to regulations and legislation, with minimal supervision. Develops standard content and delivers education programs to align policies with regulatory requirements. Conducts data management by entering practitioner/provider data to develop action plans for timely implementation.
Essential Responsibilities:
Pursues effective relationships with others by sharing resources, information, and knowledge with coworkers and members. Listens to, addresses, and seeks performance feedback. Pursues self-development; acknowledges strengths and weaknesses based on career goals and takes appropriate development action to leverage / improve them. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work. Assesses and responds to the needs of others to support a business outcome.
Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; follows procedures and policies, and applies data and resources to support projects or initiatives with limited guidance and/or sponsorship. Collaborates with others to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports the completion of priorities, deadlines, and expectations. Identifies and speaks up for ways to address improvement opportunities.
Serves as the subject matter expert for regulations within assigned areas by: maintaining and beginning to facilitate awareness of current internal policies and relevant external regulations, with minimal supervision; attending committees and beginning to support consultative guidance on the enforcement of regulations and auditing processes; and developing standard content and delivering educational programs to align organizational policies and procedures with regulatory requirements.
Conducts data management by: entering quality data into the appropriate database; and entering and reviewing consistency of required data into appropriate databases.
Ensures licensing and accreditation by: reviewing ongoing licensing and accreditations for new, existing, and expanding facilities/services to aid in achievement of compliance with state, federal, and accrediting standards, with limited guidance; consulting with other departments to ensure certification for standard cases; and beginning to conduct a basic gap analysis to identify services renewals and planning to ensure services are compliant, with limited guidance.
Conducts regulatory audits and surveys by: planning and scheduling assigned report and keeping current on regulatory requirements in preparation for surveys (e.g., NCQA, Joint Commission, AAAHC), with minimal guidance; assisting with on-site visits and evaluations as directed; leveraging standard strategies and guidelines to review, evaluate site visit criteria, and perform site visits as appropriate to ensure survey readiness, with general directions; aiding in the preparation requested audit documentation, information, and reports, with minimal supervision; and communicating to the Supervisor on the status of survey completion as required for auditing surveys, focusing on high vulnerability areas.
Minimum Qualifications:
Minimum one (1) year of experience with databases and spreadsheets.
Bachelors degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field OR minimum three (3) years of experience in business administration, health care operations, hospital environment, or a directly related field.
Additional Requirements:
Knowledge, Skills, and Abilities (KSAs): Credentialing Database Systems; Health Care Quality Standards; Delegation; Evidence-Based Medicine Principles
Preferred Qualifications:
Certified Professional in Healthcare Quality (CPHQ).
Certified Joint Commission Professional (CJCP) or credential(s) from the Healthcare Accreditation Certification Program(s) (HACP).
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