Field Compliance Specialist - RN

Heart to Heart Hospice•Plano, TX

About The Position

Field Compliance Specialist What You Must Have Registered Nurse required (active state license) Minimum of two (2) years of experience in clinical setting, preferably with Hospice, Quality/QAPI experience, and two (2) years medical-surgical experience Certified in Hospice and Palliative Care preferred Ability to train and teach staff members in the use of Home Care Home Base (HCHB), Allscripts, databases, Imaging software, E-Solutions, Maven, Nuance and etc. Good working knowledge of Local Coverage Determinants for Hospice (multiple states), Medicare Conditions of Participation (CoPs), and knowledge of the Community Health Accreditation Partners (CHAP) Ability to travel Full Time Benefits Competitive Pay Medical, Dental & Vision insurance Paid Time Off Paid holidays 401k with up to 4% employer matchingTuition reimbursement Company car for qualifying individuals Mileage reimbursement What You Will Do Audits hospice medical records and internal admin processes to monitor regulatory compliance and to ensure adherence to established processes and workflows. Identifies areas of potential risk through audit processes. Present and discuss audit findings through formal exit process. Review, approve and monitor Plan of correction. Assists the organization's compliance leadership, as directed, to research and investigate complaints, concerns or questions relative to compliance issues. Investigates and follows up on reported issues as directed. Maintains awareness of laws and regulations and conducts research as needed to identify applicable laws, regulations and practices to maintain compliance Communicates applicable eligibility and/or quality of care compliance issues to the Site, Area and Regional teams and Chief Clinical Director and Compliance Department Responds to denials and requests for additional data requests (ADRs) in an accurate and timely manner Timely submission of all documentation Performance of other duties as required Ensure overall compliance with local, state and federal laws, Medicare regulations, and established personnel policies and procedures

Requirements

Registered Nurse required (active state license)
Minimum of two (2) years of experience in clinical setting, preferably with Hospice, Quality/QAPI experience, and two (2) years medical-surgical experience
Ability to train and teach staff members in the use of Home Care Home Base (HCHB), Allscripts, databases, Imaging software, E-Solutions, Maven, Nuance and etc.
Good working knowledge of Local Coverage Determinants for Hospice (multiple states), Medicare Conditions of Participation (CoPs), and knowledge of the Community Health Accreditation Partners (CHAP)
Ability to travel

Nice To Haves

Certified in Hospice and Palliative Care preferred

Responsibilities

Audits hospice medical records and internal admin processes to monitor regulatory compliance and to ensure adherence to established processes and workflows.
Identifies areas of potential risk through audit processes.
Present and discuss audit findings through formal exit process.
Review, approve and monitor Plan of correction.
Assists the organization's compliance leadership, as directed, to research and investigate complaints, concerns or questions relative to compliance issues.
Investigates and follows up on reported issues as directed.
Maintains awareness of laws and regulations and conducts research as needed to identify applicable laws, regulations and practices to maintain compliance
Communicates applicable eligibility and/or quality of care compliance issues to the Site, Area and Regional teams and Chief Clinical Director and Compliance Department
Responds to denials and requests for additional data requests (ADRs) in an accurate and timely manner
Timely submission of all documentation
Performance of other duties as required
Ensure overall compliance with local, state and federal laws, Medicare regulations, and established personnel policies and procedures