Accreditation, Regulatory, and Licensing Specialist IV (KFHP/H)

Kaiser Permanente • Pleasanton, CA

289d

About The Position

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 risk and 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.

Requirements

• Minimum one (1) year of experience in a leadership role with or without direct reports.
• Minimum two (2) years of experience with databases and spreadsheets.
• Bachelor's degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field AND minimum five (5) years of experience in health care operations, quality, risk management, hospital environment, or a directly related field OR minimum eight (8) years of experience in health care operations, quality, risk management, hospital environment, or a directly related field.

Nice To Haves

• Knowledge of Health Care Policy.
• Health Care Data Analytics.
• Consulting skills.
• Managing Diverse Relationships.
• Delegation skills.
• Project Management skills.
• Risk Assessment skills.
• Quality Assurance Process knowledge.
• Credentialing Database Systems knowledge.
• Health Care Quality Standards knowledge.
• Evidence-Based Medicine Principles knowledge.

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.
• Maintains awareness of current internal policies and external regulations, and legislation.
• Provides consultation on the interpretation, interaction, and implementation of current policies, regulations, and legislation.
• Attends committees and 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.
• Identifies and escalates issues and seeks input from leadership to resolve.
• Conducts data management and reporting support by entering practitioner/provider data into the appropriate database.
• Independently drafts action plans/recommendations required data into appropriate databases and provides consultative expertise during implementation of action plans.
• Ensures licensing and accreditation by independently reviewing requirements for new, existing, and expanding facilities/services.
• Consults with other departments to ensure certification for moderately complex cases.
• Independently conducts a nuanced gap analysis and mentors 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.
• Coordinates with departments and external representatives to organize and support on-site visits and evaluations.
• Independently conducts, reviews, evaluating upon site visit criteria, and performing site visits as appropriate to ensure survey readiness.
• Delivers requested audit documentation, information, and reports.
• Coordinates with stakeholders within designated department to ensure the completion of required auditing surveys.
• Aids in the facilitation of educational forums and conducting standard routine audits and mock surveys within departments.
• Tracks, trends, and facilitates the development of corrective action plans (CAP) as necessary in collaboration with applicable departments.
• Collaborates 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.

What This Job Offers

• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree