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Company

City of Corpus Christi · 9 hours ago

Compliance Specialist 2 - Zone 4

South Fulton, GA

Full-time

Remote

Entry, Mid Level

2+ years exp

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Responsibilities

Under general supervision, may plan, organize or coordinate the activities of an assigned program.

Reviews, monitors and ensures compliance with assigned program area's policies and procedures.

Conducts on-site reviews, audits or surveys of clinical and treatment facilities, regulated entity operations and program management.

Conducts utilization reviews, peer reviews, evaluation activities and all other reviews on a scheduled basis.

Coordinates investigations involving noncompliance in facilities, community programs, regulated entity operations and other related programs.

Coordinates the data management and quality assurance functions.

Determines compliance with applicable state and/or federal rules and regulations.

Develops, implements and evaluates the surveillance of utilization review process to ensure quality services.

Monitors, tracks, and maintain records on compliance.

Plans and evaluates outcome studies and/or compliance findings.

Plans, develops, schedules and implements surveys and complaint investigations for licensure or certification of regulated facilities.

Plans, organizes, and directs the certification/licensing process.

Recommends programmatic and/or operational changes based on review, audit or survey results.

Reviews new rules and service site applications.

Researches and analyzes state codes, federal regulations and industry manuals regarding forms, policies and procedures.

Reviews applications for accuracy and compliance with guidelines, regulations and laws.

Performs investigations and/or audits according to established rules, regulations and other statutes.

Qualification

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Healthcare ComplianceUtilization ReviewQuality AssuranceRegistered Nurse/LPNHealthcare Facility RegulationAssociate's DegreeMental Health ExperienceDrug Treatment ExperienceAssessmentsEvaluationsTime Management Skills

Required

Master's degree in a related field from an accredited college or university OR Bachelor's degree in a related field from an accredited college or university AND Two years of related experience OR Associate's degree in a related field from an accredited college or university AND Three years of related experience OR Four years of related professional experience.

Possession of a valid Georgia driver's license, which would enable the applicant to drive in Georgia, and use of a car at work, are required for employees in this job.

Preferred

Certification(s) and/or Degree in one or more of the related fields

Experience in the field of home health and/or hospice or hospital, assisted living, private homecare, adult daycare or any licensed healthcare facility

Experience as a Registered Nurse/LPN, or licensed professional in a healthcare setting.

Experience as a Registered Nurse/LPN in the field of mental health or Drug Treatment.

Experience in utilization review and/or quality assurance in a healthcare setting.

Experience in conducting assessments and evaluations based on regulations, legal requirements and/or recognized accreditation standards.

Demonstrated ability to produce high quality documentation with attention to detail.

Strong communication and writing skills.

Strong organizational and time management skills.