Complaint, Compliance, and Enforcement Supervisor

State of Oklahoma • Oklahoma City, OK

1d • $83,000 • Onsite

About The Position

The Complaint, Compliance and Enforcement Supervisor is responsible for receiving, entering, and triage state and federal complaints for all Medical Facilities based on priorities and triage levels established by CMS and provides and assists with enforcement services. The Complaints, Compliance and Enforcement Supervisor will directly supervise complaints and enforcement personnel and complete routine survey activities.

Requirements

• Possession of a valid permanent Oklahoma license as approved by the Oklahoma Board of Nursing or recognized by the Enhanced Nurse Licensure Compact (eNLC) to practice professional nursing and nine (9) years of experience as a registered nurse OR a bachelor’s degree in nursing and eight (8) years of experience as a registered nurse.
• Applicants must provide documentation at the time of application if education, certification or licensure is required to meet qualifications.
• All applicants are subject to a background check and must be legally authorized to work in the United States without visa sponsorship.
• Knowledge of Oklahoma rules and statutes for multiple facility types.
• Knowledge of a variety of leadership practices, motivational techniques, management styles, and supervisory practices and principles; ability to apply necessary skills appropriately across a wide range of circumstances; excellent written, verbal, and interpersonal communication skills; ability to build relationships within the agency and outside the organization; ability to think critically and prioritize the agency mission, vision, and values; ability to pull data from various systems to identify trends, patterns, and opportunities for improvements.

Nice To Haves

• CMS Hospital Training
• CMS EMTALA Training
• CMS CAH Training
• CMS Home Health Training
• CMS Hospice Training

Responsibilities

• Completing all required CMS initial, on-going, and annual training to ensure knowledge of the complaint process, rules, statute, and guidance.
• Receiving incoming complaints and associated calls and inquiries for all facility types that fall under the Medical Facilities Service.
• Ensuring all complaints are immediately documented into the complaint system/database during the intake process.
• Ensuring self and staff attempts contact with complainant for 100% of complaint intakes to obtain additional needed information. Ensure contact is attempted no less than three times by self and intake staff. Ensures all attempted contact is documented with dates and times in the intake database.
• Ensuring relevant allegations are assigned to complaints based on applicable federal or state statute, regulation, and CMS guidance.
• Ensuring notification of intake is provided to applicable manager for review to facilitate high level complaints being immediately placed on the survey calendar.
• Ensuring complaint staff are knowledgeable and following all intake requirements timely.
• Ensure use of nursing and health care background to assist in assessing and capturing the complaint allegations to associate with noncompliant practices.
• Ensuring the confidentiality of all complaints received.
• Receiving, reviewing, and providing guidance on complaint intake priority based on knowledge of performing technical direct and indirect health care in a clinic, hospital, home care agency, hospice, or ambulatory surgery center, under the direction of a professional nurse, physician, or dentist.
• Provide guidance to intake staff on triage/priority based on sound nursing skills obtained through carrying out the nursing process.
• Use nurse training and practice assessing evaluation of responses to interventions, assessment, development of plans of care, proper administration of medication, and facility compliance with its own policy/procedure and compliance with federal, state and local laws, regulation and guidance.
• Analyzing and evaluating surveys to identify patient/client abuse and neglect and other deficiencies of health facilities/agencies and determine appropriate enforcement actions.
• Process immediate jeopardy and actual harm determinations; provide guidance regarding penalties and certification actions.
• Analyzing and evaluating certification or licensure surveys to determine compliance or non-compliance for initial or continued participation in state and federal programs.
• Coordinating with state and federal agencies to convey compliance or non-compliance for initial or continued participation in state and federal programs.
• Tracking enforcement action and recommending appropriate remedies.
• Analyzing and evaluating the certification actions of state and federal programs to determine completeness to ensure all state and federal documents are included and all requirements are met.
• Consulting and advising providers regarding the certification process to help facilitate reimbursement for providers and provide guidance regarding compliance or non-compliance with state and federal regulations/laws as well as subsequent applicable remedies recommended and/or imposed.
• Developing periodic staff reports, administrative audits, program activities and other information to evaluate program effectiveness, quality of service, and effective supervision of assigned staff.
• Being present at the office is an essential function of the job.
• Demonstrates knowledge of and supports mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
• Works effectively in team environment, participating and assisting their peers.

Benefits

• Generous state paid benefit allowance to help cover insurance premiums.
• A wide choice of insurance plans with no pre-existing condition exclusions or limitations.
• Flexible spending accounts for health care expenses and/or dependent care.
• Retirement Savings Plan with a generous match.
• 15 days of vacation and 15 days of sick leave the first year for full time employees.
• 11 paid holidays a year.
• Student Loan repayment options & tuition reimbursement.
• Employee discounts with a variety of companies and venders.
• Longevity Bonus for years of service

What This Job Offers

• Job Type: Full-time
• Career Level: Manager