PRTF Compliance Inspector, RN

AFMC•Little Rock, AR

1d•Remote

About The Position

Responsible for inspections and assessments to determine Psychiatric Residential Treatment Facilities (PRTFs) adherence to federal and state regulations related to the Inspections of Care (IOC) contract. Collaborate with medical and other professional staff to accomplish goals within designated timeframes. Answers directly to the outreach supervisor and is accountable for ensuring services are implemented according to strategic directives and contract deliverables. Support the organization’s mission, vision, and values by exhibiting the following behaviors: Honesty, Excellence, Accountability, Respect and Teamwork.

Requirements

Chart reviewing skills for behavioral health
Knowledge of medical necessity criteria
Knowledge restraint/seclusion documentation and incident review
Knowledge of Medicaid rules and regulations
Data analysis and sampling
Intermediate level computer skills (Excel, Word, Power Point and Outlook)
Type 50 wpm
Exceptional skills in business English and spelling
Ability to maintain confidentiality
Strong oral and written communication skills
Ability to compile presentations
Customer service
Ability to meet deadlines
Attention to detail
Flexibility
Knowledge of HIT/EHR
Medical terminology
Ability to work collaboratively and independently to achieve stated goals
Initiative
Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients, and the public
Ability to multitask
Ability to prioritize
Strong organizational skills
Problem solving skills
Professionalism
Project management skills
Ability to read, interpret and apply laws, rules, and regulations
Knowledge of quality improvement processes and techniques
Valid driver’s license and active Auto insurance required
Travel including overnight required
Time management skills
Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to travel as needed.
Must be able to lift and transport 25 pounds.
Must be capable of performing the essential job functions of this job, with or without reasonable accommodations.
Diploma or associate degree in nursing.
Licensed as a Registered Nurse in the state of Arkansas, without restrictions.
Three (3) years of experience in behavioral health, social service, or juvenile justice.
3+ years in healthcare compliance, quality, utilization review, health information management, or behavioral health operations; PRTF/under 21 inpatient psych experience strongly preferred.
Familiarity with PRTF State and Federal licensure requirements.
Reliable, high-speed wireless internet service (Wi-Fi)

Nice To Haves

Bachelor’s degree in nursing, health care, or related field.
Certified Professional in Healthcare Quality (CPHQ), Certified in Healthcare Compliance, RHIA/RHIT, or similar credentials relevant to compliance/auditing.
Experience in quality improvement or patient safety.

Responsibilities

Travel within the state as needed to accomplish required site visits, which may require overnight stays (up to 3-4 nights per week).
Enter facilities at various times outside regular work hours (evenings or early mornings) to ensure compliance with specific provider regulations.
Complete CMS required trainings related to PRTF surveys.
Conduct annual onsite PRTF surveys to ensure compliance with State and Federal regulations.
Conduct onsite PRTF complaint investigations as required.
Collaborate with team members to develop strategies to implement IOC PRTF objectives throughout the state of Arkansas.
Function as a resource for non-clinical staff by providing oversight and follow-up for clinically related questions or issues.
Write effective and accurate review summaries and submit within appropriate time frame.
Maintain files for recording and reporting in accordance with established procedures.
Seek direction from Supervisor for any questions or issues during the review process.
Participate in the planning, development, implementation, delivery, and evaluation of multiple program activities with respect to each quality of care assessment.
Communicate effectively with internal and external clients.
Utilize project-tracking database to document, collect, and interpret data to meet contractual and other reporting requirements.
Maintain accurate statistical data.
Maintain log of all onsite visits, including date, time, location, name, topics covered, feedback received, and recommendations made from the visit. The log should be entered into the project tracking system or other electronic file storage at time of visit and when onsite visit concludes.
Reports are to be completed with contract requirements for the specific provider types.
Identify, present, and discuss progress and issues relating to focus areas and suggest solutions to assist in program development.
Ensure all activities address designated performance goals and are performed within designated time frame.
Maintain knowledge of specific projects including contract, contract deliverables, policies, and procedures, etc.
Adhere to format, content, and style guidelines, considering usability and ensuring accuracy, consistency, and quality.
Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance.
Perform additional duties as assigned.