Specialist, Licensing & Accreditation

Mary Washington Healthcare•Fredericksburg, VA

4d•Onsite

About The Position

This position participates in the planning and coordination of activities designed to maintain ongoing compliance with JCAHO Standards, CMS Conditions of Participation, and State Licensure Requirements. This position assists in keeping the organization in an ongoing state of readiness for all healthcare licensing and accreditation surveys. This position will also assist in the implementation of programs and services to improve the clinical and operational performance of Mary Washington Healthcare as they relate to licensing and accreditation. This individual will support the mission, vision, values and strategic initiatives of Mary Washington Healthcare and must demonstrate a commitment to quality service to patients, physicians, the community, and co-workers.

Requirements

Bachelor’s Degree is required.
Strong analytical skills are required.
Effective communication skills are required.
Must demonstrate the ability to work effectively with all levels of the organization.

Nice To Haves

RN is preferred.
Previous experience with JCAHO Accreditation Standards, State Licensure Requirements, and CMS Conditions of Participation is preferred.
Clinical experience is preferred.

Responsibilities

Coordinates activities designed to maintain on-going compliance with all JCAHO accreditation standards.
Coordinates activities designed to maintain on-going compliance with all State Licensure requirements and Medicare Conditions of Participation.
Serve as co-leader for the Regulatory Readiness Team
Serves as an escort for External Surveyors (JCAHO, State, and CMS) when they are surveying our facilities.
Obtains literature and completes research necessary to remain current in the field of accreditation and licensing.
Participates in educational and networking programs that support efforts to comply with JCAHO and licensing standards.
Actively promotes and improves processes and educates appropriately as they relate to licensing and accreditation.
Maintains professional competency and career growth through participation in professional organizations and continuing education activities.
Performs other related duties as assigned or requested.