RN Compliance/HCHB Specialist

Karen Ann Quinlan Memorial Foundation•Newton, NJ

1d•Onsite

About The Position

This role is responsible for regulatory compliance oversight, ensuring adherence to federal, state, and local regulations including Medicare, Medicaid, CMS, and HIPAA. The specialist will conduct internal audits, stay updated on healthcare legislation, and lead the organization through accreditation and compliance surveys. Key responsibilities include developing and revising policies and procedures, leading the Quality Assurance and Performance Improvement (QAPI) committee, developing corrective action plans, and implementing compliance programs. The role also involves investigating and resolving compliance issues, educating staff, and supervising nursing staff and home health aides to ensure compliance with care plans and quality standards. Occasional oversight of the entire nursing staff may be required in the absence of clinical leadership. The position also involves maintaining accurate staff training records, assisting with visits and admissions as needed, maintaining infection control practices, and ensuring patient confidentiality.

Requirements

Ability to identify and resolve issues related to patient care, communication and compliance.
Ability to influence others in a positive manner and collaborate across the organization.
Ability to serve as a resource to employees.
Excellent interpersonal and communication skills
Ability to work and prioritize workload independently.
Ability to comprehend the spoken and written English language, to communicate with clarity both verbally and in writing.
Well organized to manage compliance functions across the organization.
Proficiency in operating a computer; including a working knowledge of Microsoft applications (Word, Excel, and Outlook) and an electronic medical record.
Bachelor of Science in Nursing, BSN is required.
Licensed to practice as a Registered Nurse in the State of New Jersey.
A minimum of two years of experience in Community Health or Home Care or Hospice care as a visiting nurse.
A minimum of one year’s experience with compliance oversight.
A minimum of one-year supervisory experience or experience in a role that requires influencing without authority.

Nice To Haves

Prior experience as a Clinical Compliance Coordinator.
Experience managing a learning management system.
Familiarity and experience with Performance Improvement, Quality Assurance processes.

Responsibilities

Ensure adherence to federal, state, and local regulations, including Medicare, Medicaid, CMS, and HIPAA.
Conduct internal audits, stay updated on healthcare legislation, and lead the organization through accreditation and compliance surveys.
Develop, revise, and ensure the review of policies and procedures in collaboration with clinical leadership to maintain compliance and improve patient care delivery.
Lead the Quality Assurance and Performance Improvement (QAPI) committee, develop corrective action plans, and monitor the implementation of process improvements.
Develop and implement compliance programs that help the organization stay within legal and ethical boundaries.
Assist in developing standards which ensure the safest and most effective service to the patient.
Assist in developing and implementing policies and procedures to ensure compliance with regulations and industry standards.
Conduct internal Compliance audits per audit schedule, create and implement action plans and maintain audit records.
Develop and implement systems for tracking compliance requirements.
Investigate, address and resolve compliance issues and concerns.
Collaborate with other departments to address compliance concerns and to develop solutions, including root cause analyses and the implementation of corrective actions.
Assist in educating staff on compliance policies, procedures and obligations.
Supervise nursing staff, home health aides, and other interdisciplinary team members at the Home for Hospice, ensuring compliance with care plans and quality standards.
Occasionally oversee the entire nursing staff, home health aides, and other interdisciplinary team members in the absence of clinical leadership.
Collaborate with Human Resources to maintain accurate and up-to-date staff training records.
Assist with visits and admissions based on business needs.
Maintain appropriate infection control practices.
Hold in strictest confidence all patient information and disclose information and data only to persons authorized by patient/family/representative or Hospice personnel.
Participate in all required in-service education programs and meetings.
Participate in 9 out of 12 nursing meetings annually.
Demonstrate compliance with the dress code policy by appearing well groomed, wearing ID badge while on duty and maintaining a professional appearance.
Perform other duties as assigned.