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National Association of Latino Healthcare Executives · 22 hours ago

Accreditation Regulatory &#038; Licensing Specialist IV (PMG)

Pasadena, CA

Full-time

Onsite

Mid Level

The National Association of Latino Healthcare Executives is dedicated to improving healthcare access and quality for Latino communities, and they are seeking an Accreditation Regulatory & Licensing Specialist IV. This role involves conducting regulatory audits, ensuring compliance with licensing and accreditation standards, and providing consultative expertise on regulatory requirements.

Health CareHospitalMedical

Responsibilities

Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome

Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions

Serves as the subject matter expert for regulations within assigned departments by: maintaining awareness of current internal policies and external regulations, and legislation; actively contributing consultative guidance on the enforcement of regulations and auditing processes; developing moderately complex content and delivering educational programs to align organizational policies and procedures with regulatory requirements; providing consultation on the interpretation, interaction, and implementation of current policies, regulations, and legislation, with guidance from senior colleagues; and identifying and escalating issues and seeking input from leadership to resolve

Conducts data management and reporting support by: entering practitioner/provider data into the appropriate database; and entering, analyzing, and independently drafting action plans/recommendations required data into appropriate databases and providing consultative expertise during implementation of action plans

Ensures licensing and accreditation by: independently reviewing requirements for new, existing, and expanding facilities/services to aid in achievement of compliance with state, federal, and accrediting standards; consulting with other departments to ensure certification for moderately complex cases; and independently conducting a nuanced gap analysis and mentoring others to identify services renewals and planning to ensure services are compliant

Conducts regulatory audits and surveys by: independently reporting moderately complex and keeping current on regulatory requirements in preparation for surveys (e.g., NCQA, Joint Commission, AAAHC); coordinating with departments and external representatives to organize and support on-site visits and evaluations; independently conducting, reviewing, evaluating upon site visit criteria, and performing site visits as appropriate to ensure survey readiness; delivering requested audit documentation, information, and reports; coordinating with stakeholders within designated department to ensure the completion of required auditing surveys, focusing on high vulnerability areas; aiding in the facilitation of educational forums and conducting standard routine audits and mock surveys within departments to ensure auditing and survey preparedness; tracking, trending, and facilitating the development of corrective action plans (CAP) as necessary in collaboration with applicable departments to assure site visit compliance; and collaborating with other departments (e.g., Revenue Cycle), gathering documents and data to support the timely completion of the annual state/federal/regulatory body reporting as required

Qualification

Regulatory complianceAuditing skillsData managementGap analysisEducational program developmentCollaborationCommunicationProblem-solvingFlexibility

Required

Conducts regulatory audits and surveys by independently reporting and keeping current on regulatory requirements in preparation for surveys

Organizes, coordinates, and conducts facilitation of on-site visits and evaluations

Performs site visits in accordance with criteria to ensure survey readiness

Ensures completion of surveys, independently

Conducts routine audits and mock surveys to aid in preparedness, tracking, trending, and 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 impact independently

Consults with departments to ensure certification and conducts moderately complex gap analyses

Serves as the subject matter expert by maintaining and facilitating 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

Develops moderately complex content and delivers education programs to align policies with regulatory requirements

Conducts data management by entering and analyzing practitioner/provider data

Independently drafts and provides consultative expertise on implementation of action plans for timely implementation

Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members

Builds relationships with cross-functional/external stakeholders and customers

Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers

Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses

Leads by influencing others through technical explanations and examples and provides options and recommendations

Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work

Champions change and helps others adapt to new tasks and processes

Facilitates team collaboration to support a business outcome

Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions

Encourages team members to adapt to and follow all procedures and policies

Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems

Escalates high-priority issues or risks, as appropriate; monitors progress and results

Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines

Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions

Serves as the subject matter expert for regulations within assigned departments by maintaining awareness of current internal policies and external regulations, and legislation

Actively contributes consultative guidance on the enforcement of regulations and auditing processes

Develops moderately complex content and delivers educational programs to align organizational policies and procedures with regulatory requirements

Provides consultation on the interpretation, interaction, and implementation of current policies, regulations, and legislation, with guidance from senior colleagues

Identifies and escalates issues and seeking input from leadership to resolve

Conducts data management and reporting support by entering practitioner/provider data into the appropriate database

Entering, analyzing, and independently drafting action plans/recommendations required data into appropriate databases and providing consultative expertise during implementation of action plans

Ensures licensing and accreditation by independently reviewing requirements for new, existing, and expanding facilities/services to aid in achievement of compliance with state, federal, and accrediting standards

Consulting with other departments to ensure certification for moderately complex cases

Independently conducting a nuanced gap analysis and mentoring others to identify services renewals and planning to ensure services are compliant

Conducts regulatory audits and surveys by independently reporting moderately complex and keeping current on regulatory requirements in preparation for surveys (e.g., NCQA, Joint Commission, AAAHC)

Coordinating with departments and external representatives to organize and support on-site visits and evaluations

Independently conducting, reviewing, evaluating upon site visit criteria, and performing site visits as appropriate to ensure survey readiness

Delivering requested audit documentation, information, and reports

Coordinating with stakeholders within designated department to ensure the completion of required auditing surveys, focusing on high vulnerability areas

Aiding in the facilitation of educational forums and conducting standard routine audits and mock surveys within departments to ensure auditing and survey preparedness

Tracking, trending, and facilitating the development of corrective action plans (CAP) as necessary in collaboration with applicable departments to assure site visit compliance

Collaborating with other departments (e.g., Revenue Cycle), gathering documents and data to support the timely completion of the annual state/federal/regulatory body reporting as required